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CASE REPORT Table of Contents   
Year : 2002  |  Volume : 36  |  Issue : 4  |  Page : 256-257
Tumoral calcinocis - A case report


Department of Orthopaedics and Pathology, ESI Hospital, Basai Dara Pur, New Delhi, India

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How to cite this article:
Lalchandani R, Sood A. Tumoral calcinocis - A case report. Indian J Orthop 2002;36:256-7

How to cite this URL:
Lalchandani R, Sood A. Tumoral calcinocis - A case report. Indian J Orthop [serial online] 2002 [cited 2019 Nov 21];36:256-7. Available from: http://www.ijoonline.com/text.asp?2002/36/4/256/35946

   Introduction Top


Deposits of calcium in abnormal locations are due to various causes. Metastatic calcification refers to a disturbance in calcium metabolism leading to calcification in normal tissues. Calcinosis is calcification in normal tissues with normal calcium metabolism. Dystrophic calcification is deposit of calcium in damaged tissues without metabolic derangement.

Tumoral calcinosis, a rare and benign calcification of periarticular soft tissues was first named by Inclan. [1] These tumors occur during the first and second decades of life. It may affect the siblings of the affected persons and may be familial. [2] Majority of cases present with a painless swelling in single or multiple periarticular regions.


   Case Report Top


A 12 years old girl presented with a painless mass in the left gluteal region. There was no history of trauma and familial involvement. The physical examination revealed a well circumscribed, 13 x 10 cm, firm to soft, non tender, non mobile mass [Figure 1]. Hip joint movements were full and painfree. Fine needle aspiration cytology revealed thick white fluid containing calcium hydroxyapatite crystals. CT scan revealed conglomerate sac like calcification in soft tisues of left gluteal region and anterolateral musculature separate from bones [Figure 2]. Serum biochemistry was normal. The mass was excised. Grossly tumor was well circumscribed [Figure 3]. On sectioning, the mass consisted of fibrous walled cystic spaces filled with pasty fluid.


   Discussion Top


Tumoral calcinosis is a distinct clinical entity characterized by tumor like periarticular deposits of calcium. Most of the cases have been reported from Africa and Papua New Guinea. [3] Some case have also been reported from S. Arabia [4] and India. [5]

In tumoral calcinosis, on laboratory evaluation, normocalcemia is seen but in many patients mild to moderate hyperphosphatemia is seen. Morphologically similar periarticular deposits may be seen in patients with chronic renal failure and secondary hyperparathyroidism. However, most of these patients are older and hypocalcemic, unlike tumoral calcinosis. Besides these patients have additional visceral calcifications also. [6] In hypervitaminosis D, similar calcifications are observed but with hypercalcemia. [7] Patients of end stage renal disease undergoing hemodialysis may also present with tumoral calcinosis. [8] Some times it may cause complications due to pressure on surrounding structures.

 
   References Top

1.Inclan A. Tumoral calcinosis. J Am Med Assoc 1943; 121: 490.  Back to cited text no. 1    
2.Salvin RE, Wen J, Kumar D, Evans BE. Familial tumoral calcinosis: a clinical, histopathologic and ultrastructural study with an analysis of its calcifying process and pathogenesis. Am J Surg Pathol 1993; 17 : 788.  Back to cited text no. 2    
3.Murthy DP. Tumoral calcinosis : A study of cases from Papua New Guinea. J Trop Med Hyg 1990; 93 : 403.  Back to cited text no. 3    
4.McGuinness FE. Hyperphosphatemic tumoral calcinosis in Bedouin Arabs clinical and radiological features.Clin Radiol 1995; 50(4) : 259-264.  Back to cited text no. 4    
5.Gautam VK, Khare GN, Nand S. Tumoral calcinosis causing carpal tunnel syndrome. Ind J Cancer 1991; 28: 228-230.  Back to cited text no. 5    
6.Parfitt AM. Soft tissue calcification in uraemia. Arch Intern Med 1969; 124 : 544.  Back to cited text no. 6    
7.Bauer JM, Freyberg RH. Vitamin D introxication with metastatic calcification. J Am Med Assoc 1946; 130 : 1208.  Back to cited text no. 7    
8.Kuzela DL, Hufter WE, Conger JD et al. Soft tissue calcification in chronic dialysis patients. Am J Pathol 1977; 86: 403.  Back to cited text no. 8    

Top
Correspondence Address:
R Lalchandani
19-C, Greenview Apartments, Near New era Public School, Mayapuri Road, New Delhi - 110 064
India
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Source of Support: None, Conflict of Interest: None


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    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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    Introduction
    Case Report
    Discussion
    References
    Article Figures
 

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