Shaukat Y M, Malik E F, Al Rashid M, Cannon S R
Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
Guy's and St Thomas' NHS Trust, United Kingdom.
Ortop Traumatol Rehabil. 2013 Oct 31;15(5):495-9. doi: 10.5604/15093492.1084363.
BACKGROUND. Tumoral calcinosis is a poorly understood phenomenon. It can be described as a syndrome of calcium deposits principally affecting the juxta-articular areas. It is a rare entity that has been poorly understood. Our aim is to highlight a special and unusual case of an 11-year-old with a large, relatively painless lump in her buttock. CLINICAL CASE. An 11-year-old girl of African descent presented to our Bone Tumour Unit after being referred by her local hospital. The girl presented with a large lump on the posterolateral aspect of the right buttock, measuring 15cm in diameter. Due to the delay in referral/diagnosis, tethering of the skin had progressed to necrosis, with a sinus discharging milky-white fluid. A MRI scan further characterised the lump as a densely calcified area within the gluteus maximus, extending to the subcutaneous tissue. The characteristic features of the calcified mass on the images led to the diagnosis of tumoral calcinosis. Laboratory test did not demonstrate any metabolic disturbances. Pathology reports further confirmed the diagnosis and the lump was successfully resected. There were no recurrences on follow-up. CONCLUSION. Several cases of tumoral calcinosis have been described in the literature; however, it remains a rare entity. Being aware of the possibility and having knowledge of tumoral calcinosis is paramount in preventing confusion and delay in diagnosis for patients and clinicians.
背景。肿瘤性钙化是一种了解甚少的现象。它可被描述为一种主要影响关节周围区域的钙沉积综合征。这是一种罕见且了解甚少的病症。我们的目的是强调一例特殊且不寻常的病例,一名11岁女孩臀部有一个较大且相对无痛的肿块。
临床病例。一名非洲裔11岁女孩在当地医院转诊后被送到我们的骨肿瘤科。该女孩右臀部后外侧有一个大肿块,直径达15厘米。由于转诊/诊断延误,皮肤粘连已发展至坏死,有一个窦道排出乳白色液体。磁共振成像(MRI)扫描进一步将肿块特征化为臀大肌内的一个致密钙化区域,延伸至皮下组织。图像上钙化肿块的特征性表现导致肿瘤性钙化的诊断。实验室检查未显示任何代谢紊乱。病理报告进一步证实了诊断,肿块成功切除。随访中无复发。
结论。文献中已描述了几例肿瘤性钙化病例;然而,它仍然是一种罕见病症。认识到这种可能性并了解肿瘤性钙化对于避免患者和临床医生的诊断困惑及延误至关重要。