Huang Yung-Tsung, Chen Chia-Yuen, Yang Che-Ming, Yao Min-Szu, Chan Wing P
School of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China.
Clin Imaging. 2006 Jan-Feb;30(1):66-8. doi: 10.1016/j.clinimag.2005.06.024.
Tumoral calcinosis-like metastatic calcification in a patient with uremia on dialysis has rarely been reported in the radiological literatures. This report describes the radiographic, scintigraphic, ultrasound, and CT findings of this condition in a 54-year-old man who had a clinical history of renal dialysis for 6 years. Elevation of serum phosphate and parathyroid hormone levels was noted. Physical examination revealed a hard, movable, and tender mass over his left arm. Plain radiographs of the left shoulder showed an amorphous massive calcification in the upper arm. Scintigraphy showed increased tracer accumulation in the soft tissue of the proximal portion of the left arm and both thighs, where CT scan revealed multilocular, amorphous, calcified masses in these areas. Scintigraphy can help in screening multiple lesions, and CT scan may further help in identifying the extent of a localized lesion such as joint involvement. Ultrasound showed localized multiloculated fluid accumulation within hyperechoic masses and perifocal interstitial fluid collection, which can help to determine the activity of the lesion. Ultrasound findings of tumoral calcinosis have not been reported before.
尿毒症透析患者出现肿瘤样钙质沉着症样转移性钙化在放射学文献中鲜有报道。本报告描述了一名有6年肾透析临床病史的54岁男性患者的这种病症的X线、闪烁扫描、超声和CT表现。血清磷酸盐和甲状旁腺激素水平升高。体格检查发现其左臂有一个坚硬、可移动且有压痛的肿块。左肩的X线平片显示上臂有不定形的大量钙化。闪烁扫描显示左臂近端和双大腿软组织中有示踪剂积聚增加，CT扫描显示这些区域有多个分隔的、不定形的钙化肿块。闪烁扫描有助于筛查多个病变，CT扫描可能进一步有助于确定局部病变的范围，如关节受累情况。超声显示高回声肿块内有局部多房性液体聚集以及病灶周围间质液聚集，这有助于确定病变的活性。肿瘤样钙质沉着症的超声表现此前尚未见报道。
