Ebot James, Nottmeier Eric
Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
J Clin Neurosci. 2019 Apr;62:243-245. doi: 10.1016/j.jocn.2018.12.015. Epub 2019 Jan 3.
Tumoral calcinosis has been defined as a pathological condition which presents as calcified masses around juxta-articular structures. The etiology of this pathology is still not well understood but degenerative spine diseases seem to play a role. The diagnosis of tumoral calcinosis preoperatively can prevent intraoperative confusion from unexpected findings, especially in cases where removal of the calcified mass is essential to treating the patient's symptoms, i.e. nerve compression causing radiculopathy.
We present two cases of patients who presented with spinal radiculopathy and mechanical pain. Both patients were found to have a calcified facet joint mass and underwent surgical resection of the mass combined with spinal fusion resulting in excellent symptom relief post-surgery.
For accurate diagnosis and management of tumoral calcinosis, a high index of suspicion together with neuro imaging remains a good place to start. Intra-operative visualization of the pathology as well as permanent pathology reports is a good adjunct to confirming the diagnosis.
肿瘤性钙化被定义为一种病理状况，表现为关节周围结构周围的钙化肿块。这种病理的病因仍未完全了解，但退行性脊柱疾病似乎起了一定作用。术前诊断肿瘤性钙化可防止术中因意外发现而产生混淆，特别是在切除钙化肿块对治疗患者症状（如导致神经根病的神经受压）至关重要的情况下。
我们介绍了两例表现为脊髓神经根病和机械性疼痛的患者。两名患者均被发现有钙化的小关节肿块，并接受了肿块手术切除并结合脊柱融合术，术后症状得到了显著缓解。
对于肿瘤性钙化的准确诊断和管理，高度的怀疑指数以及神经影像学检查仍是一个良好的开端。术中对病变的可视化以及永久病理报告是确诊的良好辅助手段。
