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Tumoral calcinosis is a disease of unknown etiology with a greater prevalence among blacks, in which subcutaneous calcifications are found around the extensor surface of the hip, shoulder, hand and occasionally the knee. They must be differentiated from other more common causes of calcification.
Tumoral calcinosis is an uncommon disease of unknown etiology characterized by the presence of single or multiple lobulated, para-articular, cystic soft tissue productions. Hyperphosphatemia is the only biological abnormality which can be detected. The honeycomb roentgenographic pattern is characteristic. CT scan and ultrasound are useful in showing the extra-articular location of the mass. The treatment is surgical and the prognosis is good.
Tumoral calcinosis is an uncommon lesion of obscure aetiology often misdiagnosed. It occurs predominantly in the Negroid and African races, but there is paucity of African literature. This is the first report of eleven cases amongst Somalis and ten Ethiopians, involving only the greater trochanteric, gluteal and iliac crest regions. The clinical, radiological, macroscopical and histological features are typical and universally similar. It may grow rapidly, but usually, gradually over the years, more frequently at the pressure points. Multiple tumours do occur; affects both the sexes and all ages, but here all the Somalis were females. Most cases in both the countries were elderly (60 to 75 years of age) in contrast to other series. Wide surgical excision is essential to avoid recurrence.
Tumoral calcinosis (TC) is an uncommon disease, characterized by deposits of large, calcified painless soft-tissue masses around major joints in otherwise healthy children and young adults. This condition is a rare inherited metabolic disorder of unknown etiology. Biochemical findings are normal except for its occasional association with hyperphosphatemia. The youngest occurrence reported in the literature on TC may be one case of a five-month-old boy. The authors report here on two younger infants with TC, one aged ten days and the other aged three months, who were followed for more than three years and observed to completely recover all motorskeletal functions.
An analysis was made of 7 cases of tumoral calcinosis diagnosed during a period of 6 years at a central laboratory serving the Igbos of Nigeria, West Africa. As in Papua New Guinea, the hip is the region of predilection and adults are usually affected, especially females. In both populations , most cases show discrete, solitary, hard, subcutaneous lesions which measure from 1 cm to 8 cm across.
A rare observation of associated universal calcinosis of the internal organs and multiple adenomatosis is described. The patient was diagnosed to have renal cystadenoma with a high content of neutral lipids in the cells; medullary thyroid carcinoma; nodular adrenal hyperplasia; microadenoma of eosinophilic cells and basophilic cell hyperplasia of the anterior hypophysis; microgangliocytoma of the hypophyseal peduncle; atrophy of the parathyroid gland. Symptoms of hypercalcemia, hypercorticoidism, and some features of the carcinoid syndrome were clinically observed. It is suggested that the clinical symptoms were due to the increased production of vitamin D3 active metabolites by the renal tumour.
Painful calcinosis appeared at the wrist of an eight-year-old girl with lead poisoning. Careful history revealed that calcification occurred at the site of previous extravasation of calcium disodium edetate (EDTA) used in chelation therapy. Light microscopic, ultrastructural, electron activation, and X-ray diffraction studies demonstrated apatites with some suggestion of an admixture of octacalcium phosphate.
A nodular mass present on the ventral surface of the tongue in a mature, castrated male domestic short-haired cat was diagnosed as calcinosis circumscripta. The cat died of end-stage renal disease. Histologically, the multilobulated mass was composed of acellular, fractured loculi separated by thin bands of a connective tissue stroma. Loculi contained a light red crystalline substance, surrounded by amorphous basophilic mineralized material. No specific relationship is suggested between the end-stage renal disease and the tongue lesion.
Male and female C3H/HeNCrl mice were divided into test groups and fed either a purified diet (AIN-76A) or a natural ingredient diet (NIH-07). Lesions of dystrophic cardiac calcinosis (DCC) were found to be more prevalent and more severe in mice fed the purified diet. The cardiac changes, which were similar in nature in both groups of mice, consisted of randomly distributed foci of myocardial mineralization and fibrosis. These lesions were not associated with clinical disease or significant alterations in serum calcium, lactic dehydrogenase, aspartate aminotransferase, alkaline phosphatase or creatine kinase levels. We conclude that AIN-76A purified diet should be utilized with caution in toxicology studies which use mice as experimental subjects, especially if the heart is a potential target organ.
The clinical presentation and radiographic findings including computed tomography is described in a case of tumoral calcinosis along with a detailed light- and electronmicroscopic analysis. Five main cell types surrounding the calcified masses were identified: fat cells, fibroblasts, macrophages, osteoclast-like giant cells and osteoblast-like cells. The light microscopic and ultrastructural findings suggest an initial tissue damage with fat necrosis and the secondary calcification process seems to be of the mitochondrial type and possibly also of the matrix vesicel type.
A case of Winer's solitary cutaneous calcinosis is used as a basis for a literature review of this rare, benign dermatosis. Despite concordant clinical features diagnosis of this lesion is histologic. Normal blood biological values, a debated etiopathogenicity and the need to eliminate a collagen disease are important factors to bear in mind before making this diagnosis of such a cutaneous lesion, for which exeresis ensures a cure.
In patients with progressive scleroderma, interstitial calcifications are present to a varying extent. They are mostly located in the soft tissues of the fingers, resembling points, commas or dashes. They may also appear as "calcinosis universalis" and reach a considerable size. Thus they mimic proliferative tumors. Scintigraphy, proving the existence of further calcifications can be helpful. We report the case of a female patient who presented with such a "pseudotumor" of unusual size, site and extent in the lumbar region.
Interstitial pulmonary calcinosis was discovered after finding hypercalcaemia in a man of 56 who had been treated for several months with Hydrochlorthiazide. This was a secondary hyperparathyroidism due to the formation of parathyroid adenomatous cysts. This illness had been quiescent until then and was probably revealed as a result of the hydrochlorthiazide therapy.
A poorly circumscribed, subcutaneous mass present on the dorsum of a young mature, male domestic short-haired cat was diagnosed as calcinosis circumscripta. Histologically, the mass was composed of multiple, fragmented loculi with a crystalline, light red center surrounded by dense, amorphous, mineralized material. Loculi were separated by variably-dense bands of a connective tissue stroma. The cat was otherwise healthy, and the mass was excised without recurrence.
The unique progression of distal interphalangeal finger joint calcinosis to total joint osteolysis in a patient with multisystem connective tissue disease is reported. Despite being anti-nuclear antibody negative, anti-Jo-1 antibody was detected.
Two patients with extensive tumoral calcinosis were treated with aluminium hydroxide. Initial metabolic studies showed positive calcium and phosphorus balances which became negative with aluminium hydroxide treatment. One subject, who had renal impairment, developed transient hypercalcaemia, parathyroid suppression, low levels of 1,25-dihydroxyvitamin D and calcium malabsorption during treatment with aluminium hydroxide. The second patient developed calcium malabsorption due to vitamin D deficiency. When she was replete with vitamin D there were supranormal levels of 1,25-(OH)2D in the serum and enhanced calcium absorption during treatment with aluminium hydroxide. Both subjects developed hypercalciuria and there was dissolution of many of the calcific tumours. The patient with renal impairment accumulated aluminium in the bone.
We report a case of a benign lymphoepithelial lesion of the parotid gland known as Godwin's tumor. This swelling of the parotid gland, appears as a tumor clinically as well as in scintigraphy and echography. The individual features of this tumor are recognized only during the histological examination: massive infiltration of the lobules of the parotid by a proliferative lymphoid tissue with differentiation to germinal centers and atrophy of the glandular acini. The treatment consists of a superficial parotidectomy. The frozen section avoids a total parotidectomy. In our case, the histological picture is quite particular due to the extensive cystic ductal dilatation and the presence of some calcifications. This aspect permit us to bring together the BLEL and the pseudotumoral calcinosis of the parotid gland. Those two lesions, occur under a context of disfunction, and they could be associated to a Gougerot-Sjögren (GS) syndrome. The BLEL could be considered as the pseudotumoral form of an isolated GS which could be completed after many years with the apparition of auto anti-bodies. The BLEL evoluates as a benign tumor but it's correlation with a malignant lymphoma or a lymphoepithelial carcinoma is also possible. Therefore it is important to follow-up these patients clinically, hematologically and immunologically after their parotidectomy.
Cases of enzootic calcinosis in breeding mares in a Southwest German highland area are reported. The symptoms increased in the latter part of summer and existed in disturbances of movement, moderate kyphosis, sensitivity to palpation in the flexor tendons and, especially, the suspensory ligament, weight loss in spite of good food intake during summer-time and painful costal percussion; less clinical signs of renal and cardiac disorders were established. The sickness was caused by a high percentage of Trisetum flavescens in the feeding plants.