Banshelkikar Santosh Nagnath, Argekar Harshad, Bhoir Asit
Department Of Orthopaedics, Lokmanya Tilak Municipal Medical College And General Hospital, Sion. Mumbai. India.
J Orthop Case Rep. 2014 Jul-Sep;4(3):59-62. doi: 10.13107/jocr.2250-0685.199.
Tumoral calcinosis is an uncommon disorder characterised by the deposition of calcium phosphate in periarticular tissues. The deposits are usually around large joints; but rarely can be found around small joints of hand and feet.
We present the case of 13 year old female with three years history of spontaneous, progressively increasing, painful swellings along right middle finger and right heel. She was otherwise well and had normal serum calcium but elevated phosphate levels. Plain radiography demonstrated a dense lobulated cluster of calcific nodules within soft tissues consistent with a diagnosis of tumoral calcinosis. This diagnosis was confirmed on the basis of histopathological examination following surgical excision.
As such tumoral calcinosis is a rare entity and with such unusual presentations like in our case, it may lead to diagnostic confusion. Tumoral calcinosis should be considered in the differential diagnosis of painful swellings developing in the vicinity of small joints of hand and feet.
肿瘤性钙化是一种罕见的疾病,其特征是磷酸钙在关节周围组织中沉积。沉积物通常围绕大关节;但在手和脚的小关节周围很少见。
我们报告一例13岁女性,有三年来沿右中指和右足跟出现自发、逐渐加重的疼痛性肿胀的病史。她其他方面健康,血清钙正常但磷酸盐水平升高。X线平片显示软组织内有密集的分叶状钙化结节群,符合肿瘤性钙化的诊断。手术切除后的组织病理学检查证实了这一诊断。
由于肿瘤性钙化是一种罕见的疾病,且有像我们病例中这样不寻常的表现,可能会导致诊断混淆。在手和脚小关节附近出现疼痛性肿胀的鉴别诊断中应考虑肿瘤性钙化。