Radiation Therapy of a Case of Ledderhose’s Disease: A Rare Benign Nodule of the Plantar Aponeurosis

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.