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Liu L, Zhao J, Hong L, Li J. Tumoral Calcinosis in the Larynx. EAR, NOSE & THROAT JOURNAL 2023:1455613231166586. [PMID: 36961766 DOI: 10.1177/01455613231166586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
Tumoral calcinosis is a rare benign disease defined as calcium salt deposits in the periarticular soft tissue region. Tumoral calcinosis is rare in the neck and larynx. In this case, we described a 58-year-old man who had numerous calcified nodules in the larynx.
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Affiliation(s)
- Lianlian Liu
- Department of Otolaryngology Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Jing Zhao
- Department of Otolaryngology Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Liu Hong
- Department of Pathology, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Jinrang Li
- Department of Otolaryngology Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Huang J, Cao LG, Zhang TR, Li SM, Meng QQ. Primary hyperphosphatemic tumoral calcinosis: a case report. Osteoporos Int 2022; 33:309-312. [PMID: 34245344 DOI: 10.1007/s00198-021-06056-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/29/2021] [Indexed: 11/26/2022]
Abstract
Tumoral calcinosis (TC) is a rare disease characterized by periarticular soft tissue calcification. Some cases were reported in Africa and the Middle East. We report an 11-year-old Chinese girl presenting with recurrent multiple subcutaneous masses around the right elbow and hip regions. Although we found abnormalities in FGF23, a protein associated with phosphate metabolism, no positive results were observed in gene sequencing and analysis. The imaging features, laboratory examination, and pathology results confirmed our diagnosis. By using oral phosphorus-lowering drugs (acetazolamide) combined with complete surgical excision, good results were achieved, and no recurrence was reported during the follow-up of 18 months. We report a case of primary hyperphosphatemic TC. The combined use of oral phosphorus-lowering drugs (acetazolamide) and complete surgical excision produced good results, and no recurrence was reported during the follow-up of 18 months.
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Affiliation(s)
- J Huang
- Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - L-G Cao
- Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - T-R Zhang
- Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - S-M Li
- Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China.
| | - Q-Q Meng
- Department of Orthopedics, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China.
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Tumoral Calcinosis: A Giant Tumoral Mass in the Shoulder Joint of a Dialysis Patient. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1730. [PMID: 29876175 PMCID: PMC5977958 DOI: 10.1097/gox.0000000000001730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 01/30/2018] [Indexed: 11/26/2022]
Abstract
Supplemental Digital Content is available in the text. Tumoral calcinosis is a rare condition in which a calcified mass grows around a large joint, and can occur in patients undergoing renal dialysis. Here, we report the case of a 64-year-old man with a long history of dialysis who presented with a giant, painless mass in his right shoulder joint. A near-complete surgical resection is performed without muscle function loss and with no sign of recurrence after 1 year.
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Abstract
Tumoral calcinosis is an extremely rare benign condition that is characterised by deposits of calcium hydroxyapatite crystals in periarticular soft tissues. Although it is mainly located around large joints such as the hips, shoulders and elbows, it may also involve the small joints of hand and wrist. There are multiple types of tumoral calcinosis with divergent clinical characteristics but the exact cause is still unknown. We present a literature review to evaluate the location, clinical features, treatment options and results of surgical excision in this condition. Wide resection appears to lead to a good clinical outcome and a low incidence of local relapse.
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Abstract
Tumoral calcinosis is a disorder characterized by deposits of calcium phosphate in the subcutaneous tissues near large joints. While often resembling a neoplasm, the soft tissue deposits of tumoral calcinosis are benign in nature. The deposits can, however, cause significant morbidity to patients due to tissue pressure or impingement. The focus of this case report will include the presentation, radiographic examinations, clinical course, and treatment of a 90-year-old female patient presenting for evaluation of a painful plantar right foot soft tissue mass associated with chronic renal failure and secondary hyperparathyroidism.
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Affiliation(s)
- Anne Sharkey
- St Joseph Hospital, Chicago, Illinois 60657, USA.
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Allameh SF, Anari AG, Gharabaghi MA, Nakhjavani M. A rare disorder: tumoral calcinosis and cirrhosis. BMJ Case Rep 2011; 2011:bcr.06.2010.3082. [PMID: 22688940 DOI: 10.1136/bcr.06.2010.3082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Tumoral calcinosis is a rare disease characterised by deposition of calcified mass near the joints. The pathogenesis of this disease is not exactly defined. A disorder of calcium and inorganic phosphate metabolism may play a role. Here, we report a case of 19-year-old girl who had both cryptogenic cirrhosis and idiopathic tumoral calcinosis. To our knowledge, there is few report of such concurrence.
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Hung JK, Chang IL, Chang HM. Surgical Excision of Tumoral Calcinosis of the Distal End of the Clavicle in a Patient With Uremia. Tzu Chi Med J 2009. [DOI: 10.1016/s1016-3190(09)60046-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Abstract
Tumoral calcinosis is an uncommon lesion, composed of ectopic calcified tissue, most commonly seen in the large joints of the hips, shoulders, and elbows, but may involve the hand and wrist. Patients will often present with localized swelling and reduced mobility around the involved joints. Pain is inconsistent when presenting in the hands or wrists, but the lesions may interfere with daily activities. Multiple variations of the process have been described, ranging from those with no definable etiology (primary), to those associated with disorders (secondary) such as renal insufficiency, hyperparathyroidism, or hypervitaminosis D. The original description of tumoral calcinosis, however, is the familial or hereditary type. Treatment of this process involves optimizing the underlying physiology and complete surgical excision for symptomatic cases.
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Calcinose pseudotumorale de localisation inhabituelle chez un patient hémodialysé. Ann Dermatol Venereol 2009; 136:350-4. [PMID: 19361703 DOI: 10.1016/j.annder.2008.10.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Accepted: 10/10/2008] [Indexed: 11/20/2022]
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Carmichael KD, Bynum JA, Evans EB. Familial tumoral calcinosis: a forty-year follow-up on one family. J Bone Joint Surg Am 2009; 91:664-71. [PMID: 19255228 DOI: 10.2106/jbjs.g.01512] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Familial tumoral calcinosis is a rare autosomal recessive disorder that was first described well in a report on four patients from one family in 1969. The disease leads to periarticular ectopic calcifications. The original report described patients from black, healthy, unrelated parents with sixteen children, seven of whom had the disease. METHODS On the basis of retrospective chart reviews and interviews with surviving family members, we describe the long-term follow-up of this one family, encompassing as long as forty years. Of the sixteen siblings, seven had tumoral calcinosis. RESULTS All seven affected children had hyperphosphatemia. There were two subsequent generations comprising thirteen children and seven grandchildren with no instances of tumoral calcinosis. The seven affected patients were followed for as many as forty years and underwent an average of twenty-one operations (range, four to thirty-six operations) for the treatment of calcified lesions. The genetic defect has been identified as the GALNT3 gene, thus leading to the hyperphosphatemic form of the disease. Although two of the patients had died by the time of the present study, the remaining five provided accounts of the disease course, the response to surgery and to medical therapy, and the effect of therapy on their lives. Some members had relatively few lesions and surgical procedures (as few as four), whereas others had an unrelenting course of lesions, recurrences, and surgical procedures (as many as thirty-six, with numerous other procedures). Three patients had multiyear periods with few symptoms--one for seven years, one for twelve years, and one for fifteen years. No effective medical therapy was found to control the lesions, and operations were associated with a high recurrence rate. CONCLUSIONS Familial tumoral calcinosis has a varied natural history; some patients have an unrelenting course, while others may experience quiescent periods. The GALNT3 gene is responsible for the hyperphosphatemic form as seen in this family. Molecular testing may be of benefit to members of affected families, and future studies may help to explain the phenotypic variability among affected individuals. No medical or surgical treatment plan seemed to be effective for controlling the lesions in this family.
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Affiliation(s)
- Kelly D Carmichael
- Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0353, USA.
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Nonfamilial hyperphosphatemic tumoral calcinosis with ulnar neuropathy. Joint Bone Spine 2008; 76:198-201. [PMID: 19073370 DOI: 10.1016/j.jbspin.2008.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Accepted: 06/05/2008] [Indexed: 01/26/2023]
Abstract
We present a case of multiple large juxta-articular painless masses involving both the elbows and right hip in a 27-year old south Asian male who presented with ulnar neuropathy and constitutional symptoms. Radiology, blood investigations and biopsy confirmed it to be hyperphosphatemic tumoral calcinosis. Patient was also diagnosed with an extremely rare association, testicular microlithiasis. Complete surgical excision with low phosphate diet resulted in complete neurological recovery and no recurrence at 30 months. Tumoral calcinosis should be considered in the differential diagnosis of a case with multiple, symptomatic juxta-articular masses.
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Prasad J, Malua S, Sinha DK, Hassan F, Tekriwal R. Tumoral calcinosis: a case report. Indian J Surg 2007; 69:251-3. [PMID: 23132997 DOI: 10.1007/s12262-007-0036-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2006] [Accepted: 10/15/2007] [Indexed: 10/22/2022] Open
Abstract
Tumoral Calcinosis is a distinct clinical and histological entity that is characterized by large periarticular deposits of calcium resembling a neoplasm and is found foremost in the region of hip, shoulder and elbow. We report a case of Tumoral Calcinosis in a 25-year-old male who presented to us with gradually increasing swelling of right axilla, and both hips of nearly two years duration. It was diagnostic enigma for the treating surgeons but with the help of an astute pathologist we diagnosed this rare condition and successfully treated it surgically.
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Affiliation(s)
- J Prasad
- Department of Surgery, RIMS, Ranchi, 834 009 India
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Williams Z, Amrami KK, Spinner RJ. Tumoral calcinosis producing peripheral nerve compression: a report of two cases. Neurosurg Focus 2007; 22:E20. [PMID: 17613212 DOI: 10.3171/foc.2007.22.6.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Tumoral calcinosis is a rare disorder that leads to diffuse calcium phosphate deposition into soft tissue and may be seen in the setting of uremia, hyperparathyroidism, or vitamin D intoxication. This lesion can produce significant local pain and can limit mobility in large joints where it tends to occur. Less commonly, it may produce neurological symptoms by compressing or encompassing adjacent neurovascular structures. Tumoral calcinosis involving nerve structures is challenging to treat, primarily because of its extensive size and propensity to infiltrate. Although surgical intervention can often provide symptomatic improvement, this lesion tends to recur in the presence of elevated calcium phosphate levels, and its management therefore requires a combined multidisciplinary surgical and medical approach. The authors describe two cases in which patients developed tumoral calcinosis producing peripheral nerve compression and discuss their respective surgical and medical management.
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Affiliation(s)
- Ziv Williams
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota 55902, USA
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Douira L, Ismaili N, Raiss M, Bensaleh H, Senouci K, Hassam B, Mansouri F. Calcinose tumorale d’Inclan. Ann Dermatol Venereol 2007; 134:464-7. [PMID: 17507846 DOI: 10.1016/s0151-9638(07)89215-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Tumoral calcinosis is a rare disease seen in adolescents and young adults and consisting of calcifications in periarticular soft tissue. Mutations in fibroblast growth factor 23 and GalNAc transferase 3 have been identified in the familiar forms of tumoral calcinosis. PATIENT A 10 year-old boy of light phototype presented multiple calcified periarticular masses since the age of seven years as well as sciatica secondary to nerve compression. Laboratory examinations revealed hyperphosphoraemia. Serum calcium levels, kidney tests, parathormone assay and muscle enzymes were all normal. Histology of a cutaneous biopsy sample revealed dermal calcifications. Inclan's tumoral calcinosis was diagnosed. Surgical resection was performed and drug treatment comprising phosphate chelators (aluminium hydroxide) was administered. At five months, other sites were apparent. DISCUSSION This case of tumoral calcinosis is notable in terms of its sporadic onset in a child of light phototype and by the presence of compression of the external sciatic nerve. The diagnosis was made after ruling out other causes of soft tissue calcification.
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Affiliation(s)
- L Douira
- Service de Dermatologie, CHU Ibn Sina, Rabat, Maroc.
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Shibuya S, Kawaguchi Y, Arima N, Yamamoto T, Dobashi H, Tokuda M. Tumoral calcinosis in bilateral facet joints of the lumbar spine in scleroderma. J Neurosurg Spine 2006; 5:451-4. [PMID: 17120897 DOI: 10.3171/spi.2006.5.5.451] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
✓Tumoral calcinosis commonly occurs in the articular soft tissues of the extremities but rarely in the spine. The authors performed surgery to treat lumbar tumoral calcinosis in a patient with scleroderma, in whom symptoms of neurological dysfunction had manifested.
This 49-year-old woman presented with low-back pain and gait disturbance. Seven years before presentation, scleroderma had been diagnosed, and the patient had received medical treatment ever since. Imaging revealed tumoral calcinosis centered at the bilateral facet joints between L-3 and L-4, marked stenosis of the spinal canal, L-3 spondylolisthesis, and intervertebral instability. Surgery was performed to excise the lesion en bloc. After neural decompression, posterolateral fusion and pedicle screw fixation were undertaken. Symptoms improved after surgery.
In this case, the underlying scleroderma that predisposes to calcinosis and facet joint degeneration due to lumbar spondylolisthesis were probably factors leading to the development of tumoral calcinosis in the lumbar spine.
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Affiliation(s)
- Sei Shibuya
- Department of Orthopaedic Surgery, School of Medicine, Kagawa University, Kagawa, Japan.
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Affiliation(s)
- Federico Giardina
- First Department of Orthopedic Surgery, Istituti Ortopedici Rizzoli, Bologna, Italy
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Polykandriotis EP, Beutel FK, Horch RE, Grünert J. A case of familial tumoral calcinosis in a neonate and review of the literature. Arch Orthop Trauma Surg 2004; 124:563-7. [PMID: 15340747 DOI: 10.1007/s00402-004-0715-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2003] [Indexed: 02/09/2023]
Abstract
BACKGROUND Tumoral calcinosis occurs in two distinct clinical forms. The sporadic form is secondary to chronic renal failure, hyperparathyroidism, milky-alkali syndrome, hypervitaminosis D and other systemic disorders. The familial form is extremely rare (around 100 cases worldwide) and affects patients in the first or second decade of life. It is believed to be transmitted in a dominant autosomal manner with variable clinical expressivity and is manifested as hyperphosphatemia, elevated serum 1,25-dihydroxyvitamin D with juxta-articular tumorous calcifications. Moreover, the theory of a unique dental malformation serving as a screening marker for clinically non-apparent affected individuals is revisited and reconfirmed. CASE REPORT We present a case of a Caucasian male newborn, as well as a review of the literature with differential diagnostic considerations and their therapeutical implications.
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Affiliation(s)
- Elias P Polykandriotis
- Department of Plastic and Hand Surgery, Chirurgische Klinik mit Poliklinik, University of Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany.
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Aydin A, Tuncer S, Erer M, Bilgic B. Tumoral calcinosis infiltrating the biceps brachii tendon - excision and reconstruction with allograft: a case report. ACTA ACUST UNITED AC 2004; 29:170-2. [PMID: 15010166 DOI: 10.1016/j.jhsb.2003.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2003] [Accepted: 11/03/2003] [Indexed: 10/26/2022]
Abstract
Two patients with limited elbow motion due to tumoral calcinosis underwent resection of calcified masses around the elbow joints. This necessilated removal of the distal two thirds and three fourths of the biceps muscles. The resulting defects were reconstructed with homologous Achilles tendon grafts. Both patients regained M4 muscle power and no recurrences were observed.
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Affiliation(s)
- A Aydin
- Section of Hand Surgery, Department of Plastic and Reconstructive Surgery, and the Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Hoelzler MG, Goring RL, Kennedy FS. What is your diagnosis? A lobular, periarticular, mineralized soft-tissue opacity in the region of the subscapularis muscle. J Am Vet Med Assoc 2001; 219:1525-6. [PMID: 11759985 DOI: 10.2460/javma.2001.219.1525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- M G Hoelzler
- Affiliated Veterinary Specialists PA, Orange Park, FL 32073, USA
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ASSOCIATION BETWEEN TRANSFORMING GROWTH FACTOR BETA 3 AND CLEFT LIP AND/OR PALATE IN THE JAPANESE POPULATION. Plast Reconstr Surg 2001. [DOI: 10.1097/00006534-200106000-00049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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