Authors :
M. Taouchikht; S. Abdou; H. Fares; K. Nouni; A. Lachgar; H. El Kacemi; T. Kebdani; K. Hassouni
Volume/Issue :
Volume 9 - 2024, Issue 9 - September
Google Scholar :
https://tinyurl.com/2tjb56na
Scribd :
https://tinyurl.com/2km9avaw
DOI :
https://doi.org/10.38124/ijisrt/IJISRT24SEP387
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Ledderhose’s disease, or plantar fibromatosis,
is a rare benign condition characterized by the excessive
proliferation of connective tissue in the plantar
aponeurosis, leading to slow-growing nodules. Although
it usually presents unilaterally, bilateral involvement
occurs in about 25% of cases. The exact cause is
unknown, but associations with diabetes mellitus, liver
disease, and repeated trauma have been noted.
Treatment options are diverse, with surgery often being
the primary approach, but radiation therapy has
emerged as a promising alternative.
We present the case of a 70-year-old Moroccan man
with a painful plantar nodule, diagnosed with
Ledderhose’s disease. Initial measures were insufficient,
leading to the use of radiation therapy. The patient
received Three-Dimensional Conformal Radiotherapy
(3D-CRT) at a dose of 30.0 Gy, administered in two
courses. Following treatment, the patient experienced
significant symptom relief and a notable reduction in
nodule size. Although surgery was eventually required
due to disease progression, it is noteworthy that
radiation therapy effectively delayed the need for
surgical intervention.
References :
- Ledderhose G. Zur Pathologie der Aponeurose des Fußes und der Hand. Langenbecks Arch Klin Chir 1897;55:694–712.
- S. Banerjee, M. Muhammad, C. Nath, and D. Kumar Pal, “Plantar fibromatosis: a case report,” The Foot and Ankle Online Journal, vol. 2, no. 12, article 3, 2009.
- Kashuk KB, Pasternack WA. Aggressive infiltrating plantar fibromatosis. J Am Podiatry Assoc 1981;70:491–6.
- D. F. de Souza, L. Micaelo, T. Cuzzi, and M. Ramos-e-Silva, “Ledderhose disease—an unusual presentation,” Journal of Clinical and Aesthetic Dermatology, vol. 3, no. 9, pp. 45–47, 2010.
- A. L. Van Rijssen and P. M. N. Werker, “Percutaneous needle fasciotomy in Dupuytren’s disease,”The Journal of Hand Surgery, vol. 31, no. 5, pp. 498–501, 2006.
- E. de Bree, F. A. N. Zoetmulder, R. B. Keus, H. L. Peterse, and F. Van Coevorden, “Incidence and treatment of recurrent plantar fibromatosis by surgery and postoperative radiotherapy,” The American Journal of Surgery, vol. 187, no. 1, pp. 33–38, 2004.
- Bruno Gonçalves Schröder e Souza, “Surgical Treatment of a Case of Ledderhose’s Disease: A Safe Plantar Approach to Subtotal Fasciectomy” Case Reports in Orthopedics Volume 2015.
- Beckmann, Kalteis T, Baer W, et al. Plantarfibromatose: Therapie mit totaler Plantarfasziektomie. Zentralbl Chir 2004;129:53–7.
- Seegenschmiedt MH, Attassi M. Strahlentherapie beim Morbus Ledderhose – Indikation und klinische Ergebnisse. Strahlenther Onkol 2003;179:847–53.
- Heyd, R., Dorn, A. P., Herkströter, M., Rödel, C., Müller-Schimpfle, M., & Fraunholz, I. (2009). Radiation Therapy for Early Stages of Morbus Ledderhose. Strahlentherapie Und Onkologie, 186(1), 24–29.
- M.L. Smith, C.L. Matthiesen, A.N. Arain, T.S. Herman .The Efficacy of Radiation Therapy for Dupuytren’s Contracture and Morbus Ledderhose (2015). International Journal of Radiation Oncology, ASTRO
- Radiation Therapy Oncology Group. Acute radiation morbidity scoring criteria http://www.rtog.org/ResearchAssociates/AdverseEventReporting/AcuteRadiationMorbidityScoringCriteria. aspx
- M. Trybus, M. Bednarek, P. Budzynski, M. Gniadek, and J. Lorkowski, “Concomitance of Ledderhose's disease with Dupuytren's contracture. Own experience,” Przegląd Lekarski, vol. 69, no. 9, pp. 663–666, 2012.
- E. A. Oliveira, T. Pato, and A. Barcelos, “Ledderhose disease—a clinical case,” Acta Reumatologica Portuguesa, vol. 35, no. 4, pp. 529–530, 2010.
- H. R. Dürr, A. Krödel, H. Trouillier, A. Lienemann, and H. J. Refior, “Fibromatosis of the plantar fascia: diagnosis and indications for surgical treatment,” Foot and Ankle International, vol. 20, no. 1, pp. 13–17, 1999.
- A. M. Halefoğlu, “The use of magnetic resonance imaging in the diagnosis of plantar fibromatosis: a case report,” Acta Orthopaedica et Traumatologica Turcica, vol. 39, no. 2, pp. 176–179, 2005.
- Z. S. Hammoudeh, “Collagenase clostridium histolyticum injection for plantar fibromatosis (Ledderhose disease),” Plastic and Reconstructive Surgery, vol. 134, no. 3, pp. 497e–498e, 2014.
- K. Knobloch and P. M. Vogt, “High-energy focussed extracorporeal shockwave therapy reduces pain in plantar fibromatosis (Ledderhose’s disease),” BMC Research Notes, vol. 5, article 542, 2012.
- S. Grenfell and M. Borg, “Radiotherapy in fascial fibromatosis: a case series, literature review and considerations for treatment of early-stage disease,” Journal of Medical Imaging and Radiation Oncology, vol. 58, no. 5, pp. 641–647, 2014.
- Seegenschmiedt MH (2008) Morbus Dupuytren/Morbus Ledderhose. In: Seegenschmiedt MH, Makoski HB, Trott KR, Brady LW (eds) Radiotherapy for non-malignant disorders. Contemporary concepts and clinical results. Springer, Berlin, pp 161–191
- Seegenschmiedt MH, Wielpütz M, Hanslian M et al (2012) LongTerm outcome of radiotherapy for primary and recurrent Ledderhose disease. In: Eaton C et al (eds) Dupuytren’s disease and related hyperproliferative disorders. Springer, Berlin, pp 409–427
- Heyd R, Buhleier T, Zamboglou N. Radiation therapy for prevention of heterotopic ossification about the elbow. Strahlenther Onkol 2010;185: 506–11.
- Heyd R, Tselis N, Ackermann H, et al. Radiation therapy for painful heel spurs. Results of a prospective randomized study. Strahlenther Onkol 2007;183:3–9.
- Janssen S, Johann H, Karstens H. Endokrine Orbitopathie – Wie effektiv ist die Strahlentherapie. Strahlenther Onkol 2010;185:61–2.
- Rödel F, Kamprad F, Sauer R, et al. Funktionelle und molekulare Aspekte der antiinflammatorischen Wirkung niedrig dosierter Strahlentherapie. Strahlenther Onkol 2002;178:1–9.
- Gärtner, A., et al. (2010). "Efficacité de la radiothérapie dans le traitement de la maladie de Ledderhose." Journal of Dermatological Treatment, 21(2), 112-116.
- Doyon, F., et al. (2014). "Résultats à long terme de la radiothérapie pour la maladie de Ledderhose." Clinical Oncology, 26(3), 171-176.
- Kwan, W., et al. (2015). "Surgical management of Ledderhose's disease: A review of current practices and outcomes." Foot & Ankle Specialist, 8(1), 32-37
- Rappaport, J., et al. (2016). "Comparative effectiveness of surgery and radiotherapy for Ledderhose’s disease: A systematic review." Journal of Surgical Oncology, 113(6), 657-663.
- Miller, R., et al. (2018). "Combination therapy for Ledderhose’s disease: Surgery followed by radiotherapy." Dermatologic Surgery, 44(4), 564-570
Ledderhose’s disease, or plantar fibromatosis,
is a rare benign condition characterized by the excessive
proliferation of connective tissue in the plantar
aponeurosis, leading to slow-growing nodules. Although
it usually presents unilaterally, bilateral involvement
occurs in about 25% of cases. The exact cause is
unknown, but associations with diabetes mellitus, liver
disease, and repeated trauma have been noted.
Treatment options are diverse, with surgery often being
the primary approach, but radiation therapy has
emerged as a promising alternative.
We present the case of a 70-year-old Moroccan man
with a painful plantar nodule, diagnosed with
Ledderhose’s disease. Initial measures were insufficient,
leading to the use of radiation therapy. The patient
received Three-Dimensional Conformal Radiotherapy
(3D-CRT) at a dose of 30.0 Gy, administered in two
courses. Following treatment, the patient experienced
significant symptom relief and a notable reduction in
nodule size. Although surgery was eventually required
due to disease progression, it is noteworthy that
radiation therapy effectively delayed the need for
surgical intervention.