Indian Journal of Orthopaedics

CASE REPORT
Year
: 2006  |  Volume : 40  |  Issue : 1  |  Page : 52-

Tumoral calcinosis - A case report


Dilip Magarkar, Sulabha Magarkar, Abhijit Deo, Kiran Saoji 
 Department of Orthopaedics, Nagpur Nagrik Sahkari Rugnalaya and Research Center, Nagpur, India

Correspondence Address:
Dilip Magarkar
Department of Orthopaedics, Nagpur Nagrik Sahkari Rugnalaya and Research Center, Nagpur
India




How to cite this article:
Magarkar D, Magarkar S, Deo A, Saoji K. Tumoral calcinosis - A case report.Indian J Orthop 2006;40:52-52


How to cite this URL:
Magarkar D, Magarkar S, Deo A, Saoji K. Tumoral calcinosis - A case report. Indian J Orthop [serial online] 2006 [cited 2020 Feb 17 ];40:52-52
Available from: http://www.ijoonline.com/text.asp?2006/40/1/52/34434


Full Text

 Introduction



Tumoral calcinosis is a rare tumor-like condition, which often mimics tumor. It occurs around the joint in periarticular soft tissue [1] . This is relatively uncommon non-neoplastic disorder. We report a case of tumoral calcinosis around elbow in 13 years old female.

 Case report



A 13-year-old female child presented with swelling around left elbow, 6cm by 10 cm in size, of 6 months duration, gradually increasing in size. There was no pain and elbow movements were spared. There was no history of trauma, fever or any systemic illness. On examination, the swelling was 6cm by 10cm situated over extensor aspect of elbow, lobulated soft to firm in consistency and non- tender. Overlying skin was non-errythematous. Movements of elbow, extension, flexion, supination and pronation of forearm were normal.

Radiograph showed lobulated, homogenous calcified masses situated around extensor surface of the bone, independent of bone and joints. The lobulated calcified masses had intervening lucent septae, giving it a multi­loculated appearance.

The patient was treated with excision of the mass. Operative finding demonstrated that the swelling was lobulated and capsulated. Capsule was thinned at places and pouring out chalky white toothpaste like material. Swelling was dissected right upto the bone and extension of the lesion was found into olecranon fossa. Grossly lesion was capsulated multinodular with white chalky material inside. Histology revealed heavy calcium deposits in the fibrous stroma with mild reactive inflammatory-cell infiltrate. Typically cartilaginous features are absent.

 Discussion



Tumoral calcinosis is uncommonly reported in India. The larger series have been reported from African countries. The swelling usually occurs along the extensor surface in periarticular soft tissue as large painless calcified masses. Hips and elbows are the most common site. Curiously the knee is always spared. The disease usually occurs in age group of 8 to 15years and has genetic basis and inherited as an autosomal dominant trait with variable clinical expressivity [2] . Blood chemistry shows normal calcium level. There is hyperphosphataemia and elevated serum dihydroxy vitamin D level [3] . Surgical removal is the treatment of choice, incomplete resection leads to recurrence.

This lesion can be easily differentiated from other soft tissue calcification, renal osteodystrophy, chondrosarcoma, paraosteal osteosarcoma.

References

1Grainger RG, Allison D, Adam A, Dixon AK. Diagnostic radiology: a textbook of medical imaging. 4th Ed; Churchill Livingstone, Philadelphia, 2001: Vol -3, p - 2085. 49:721-731,1967.
2Lyles KW, Burkes EJ, Ellis GJ, Lucas EJ, Dolan EA, Drezner MK. Genetic transmission of tumoral calcinosis. Autosomal dominant with variable clinical expressivity. Clin Endocrinal Metab. 1985; 60:1093-1096.
3Baldursson H, Evan EB, Dodge WF, Jackson WT. Tumoral calcino­sis with hyperphosphatemia. A report of a family with incidence in 4 siblings. J Bone Joint Surg (Am). 1969; 51: 913 - 925.