Presentation
IC presents in juxta-articular tissue in a tumour-like fashion is known as idiopathic tumoral calcinosis (ITC). Recurrent trauma and chronic pressure are thought to be the triggering factors. It usually presents in adolescents and adults. [ncbi.nlm.nih.gov]
Entire Body System
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Soft Tissue Swelling
Our case report introduces two Sudanese siblings from consanguineous parents who presented with simultaneous recurrent multiple soft tissue swellings. [ncbi.nlm.nih.gov]
An X-ray of the skull revealed chunky calcification over the area of the mass with no underlying destruction of bone, periosteal reaction, or soft tissue swelling [Figure 3]. X-ray lateral view right foot showed similar findings [Figure 4]. [cjhr.org]
It is characterized by single or multiple painless, lobular, well-demarcated periarticular soft tissue swelling/s. [ijo.in]
Radiograph of the foot shows radiopaque soft-tissue swelling at the great toe with underlying erosive changes of the adjacent osseous structures. Figure 18. Calcific myonecrosis in a 62-year-old man with a remote history of leg trauma. [pubs.rsna.org]
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Fever of Unknown Origin
Unexpected inflammatory activity of tumoral calcinosis periarticular to the shoulders and hips in a man with recurrent fever of unknown origin and dialysis-dependent kidney insufficiency was revealed by FDG PET/CT. [ncbi.nlm.nih.gov]
Due to the general fatigue, anorexia, fever of unknown origin and inflammatory syndrome, and considering the endemic state of TB in our country and the protein rich ascites effluent with high lymphocyte count, tuberculosis peritonitis was suspected. [sjkdt.org]
Respiratoric
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Aspiration
Aspiration cytology of this condition has been rarely reported. We describe the aspiration cytology findings of a recent case of TC and discuss possible differential diagnoses. [ncbi.nlm.nih.gov]
Subsequently about 300 ml to 500 ml viscous fluid was aspirated 5 times from the left gluteal swelling. Patient serum phosphate level decreased but lesions did not show any improvement so surgery was performed. [ijoonline.com]
Gastrointestinal
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Dysphagia
Herein, to their knowledge the authors present the first case of tumoral calcinosis affecting the craniovertebral junction in a patient who presented with severe dysphagia and required transoral decompression. [ncbi.nlm.nih.gov]
There may be dysphagia and respiratory involvement. • Muscle biopsy: type I and II necrosis fibers, phagocytosis, regeneration with basophilia, sarcolemnic nuclei, large vesicles, prominent nucleolus, atrophy with perifascicular distribution, fibers of [elsevier.es]
Musculoskeletal
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Joint Stiffness
Orthopedic surgeons are often consulted for diagnosis of MASS syndrome, imaging showing periarticular calcification, or joint stiffness. [ncbi.nlm.nih.gov]
Face, Head & Neck
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Neck Mass
A computed tomography (CT) scan was performed as part of his workup, and a posterior cervical neck mass was detected. CT-guided fine needle aspiration was performed with an immediate cytologic interpretation of tumoral calcinosis. [ncbi.nlm.nih.gov]
A 48-year-old woman with scleroderma and left neck mass. No history of prior trauma. No other significant contributory medical or surgical history. View Case [ajnr.org]
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Neck Swelling
After 2 years of parathyroidectomy, the neck swelling again started increasing in size with increase in serum parathormone levels. [ncbi.nlm.nih.gov]
Neurologic
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Radiculopathy
We present two cases of patients who presented with spinal radiculopathy and mechanical pain. [ncbi.nlm.nih.gov]
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Lower Extremity Spasticity
In this report, the authors describe the management of the first case of intramedullary TC located at the T-5 level in a 20-month-old boy who presented with lower-extremity spasticity. [ncbi.nlm.nih.gov]
Workup
A computed tomography (CT) scan was performed as part of his workup, and a posterior cervical neck mass was detected. CT-guided fine needle aspiration was performed with an immediate cytologic interpretation of tumoral calcinosis. [ncbi.nlm.nih.gov]
X-Ray
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Muscle Calcification
Computed tomography (CT) scan showing calcifications in an adult with HFTC including shoulder and hip soft tissue calcifications (white arrows), aortic calcification (dashed arrow), papillary muscle calcification (black arrow), and submucosal gut calcifications [ncbi.nlm.nih.gov]
Treatment
It can be considered an effective alternative treatment for tumoral calcinosis if surgical treatment is not feasible. [ncbi.nlm.nih.gov]
Nonoperative observation indications treatment of choice for non-symptomatic lesions Operative complete surgical excision indications treatment of choice for symptomatic lesions technique complete surgical excision is required to decrease the rate of [orthobullets.com]
Prognosis
[…] milky fluid Microscopic • Nodules have large areas of amorphous or granular calcium masses • May have interspersed calcopherites • Calcium crystals exhibit hydroxyapatite • Macrophage infiltration, osteoclast-like giant cells, inflammatory cells present PROGNOSIS [tumorsurgery.org]
Although the pathogenesis of the calcification process in tumoral calcinosis is still controversial, surgical removal remains the mainstay treatment with a satisfactory prognosis. References 1. Weiss, SW.; Goldblum, JR. [ccmbm.com]
Infectious complications of these lesions are associated with poor prognosis. [4] Tumoral calcinosis is a rare inherited metabolic disorder characterized by massive calcium and phosphate deposits. [5] It is rare in dialyzed patients, [6] and its pathogenesis [sjkdt.org]
It is also important to follow-up these patients as the cardiovascular prognosis is poor due to accelerated vascular calcification. [elsevier.es]
Etiology
TC is a disorder of obscure etiology with typical clinical, radiologic, cytologic and histopathologic features. [ncbi.nlm.nih.gov]
TERMINOLOGY Synonyms Lipid calcinosis Calcifying collagenolysis Tumoral lipocalcinosis Definitions Extraskeletal soft tissue calcification with granulomatous response ETIOLOGY/PATHOGENESIS Etiology Theories Inborn error of phosphorus metabolism Associated [basicmedicalkey.com]
Epidemiology
Introduction Rare and poorly understood hereditary metabolic dysfunction of phosphate regulation associated with massive periarticular calcinosis in the extra-capsular soft tissues Epidemiology demographics more common in females and African-Americans [orthobullets.com]
Chondrocalcinosis Allowable Qualifiers English : BL blood CF cerebrospinal fluid CI chemically induced CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology [decs.bvs.br]
Pathophysiology
Identification of this pathophysiology extends the etiologic spectrum of hyperphosphatemic tumoral calcinosis and suggests that immunomodulatory therapy may be an effective treatment. Authors Mary Scott Roberts, Peter D. [jci.org]
[…] calcinosis in the extra-capsular soft tissues Epidemiology demographics more common in females and African-Americans onset in childhood or early adolescence location around joints, primarily the hip ( trochanteric bursa is most common location) shoulder Pathophysiology [orthobullets.com]
The recent identification of a fusion of fibronectin and fibroblast growth factor receptor 1 (FGFR1) as a molecular driver in some tumours not only sheds light on the pathophysiology of TIO but also opens the door to a better understanding of the transcription [natureasia.com]
Tumoral calcinosis revisited: pathophysiology and treatment. Rheumatol Int. 2005; 25(1):55-9. 7. Kim HS, Suh JS, Kim YH, Park SH. Tumoral calcinosis of the hand: three unusual cases with painful swelling of small joints. [oapublishinglondon.com]
Pathophysiology Deficiency of or resistance to FGF23 leads to hyperphosphatemia resulting in increased renal phosphate reabsorption and elevated or inappropriately normal 1,25D production, which promotes gastrointestinal absorption of phosphorus and calcium [ncbi.nlm.nih.gov]
Prevention
A concise review of the pertinent literature focusing on the diagnosis, treatment options, and preventive measures also is reported. This journal requires that authors assign a level of evidence to each article. [ncbi.nlm.nih.gov]
Determine whether calcitonin reduces or prevents tumor recurrence. III. Determine whether hyperphosphatemia abolishes the normal circadian pattern of serum phosphorus. IV. [clinicaltrials.gov]