Basnayake Oshan, Jayarajah Umesh, Beneragama Thushan
Departments of Anatomy and Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Plastic and Reconstructive Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
SAGE Open Med Case Rep. 2023 Jan 17;11:2050313X221150715. doi: 10.1177/2050313X221150715. eCollection 2023.
Calcinosis cutis is a type of heterotopic calcification where abnormal calcium deposition occurs in skin or subcutaneous tissue. Among the subtypes of calcinosis cutis, the idiopathic variety occurs without underlying biochemical calcium abnormality. We report a rare case of idiopathic calcinosis cutis causing cubital tunnel syndrome. A 63-year-old female presented with pain and numbness in the ulnar aspect of her left hand. The X-ray of the left elbow showed deposition of radiopaque material on the posteromedial aspect. Her nerve conduction study showed evidence of ulnar nerve compression at the elbow supporting the diagnosis of ulnar nerve compression by the mass of calcium deposition. Surgical exploration was performed, and significant ulnar nerve compression was noted due to the mass effect of the calcium deposition. Excision of the mass and ulnar nerve decompression with anterior transposition was performed with satisfactory outcomes. Although calcinosis cutis causing cubital tunnel syndrome has been previously reported, all patients had some form of calcium dysregulation. We report the first case of ulnar nerve compression at the cubital tunnel due to idiopathic calcinosis cutis. Excision of the mass and ulnar nerve decompression with anterior transposition was successful in our patient despite the incomplete excision of the calcium deposition.
皮肤钙化症是一种异位钙化,表现为皮肤或皮下组织出现异常钙沉积。在皮肤钙化症的亚型中,特发性类型的发生不存在潜在的生化钙异常情况。我们报告一例罕见的特发性皮肤钙化症导致肘管综合征的病例。一名63岁女性因左手尺侧疼痛和麻木前来就诊。左肘部X线显示在后内侧有不透射线物质沉积。她的神经传导研究表明肘部尺神经受压,支持钙沉积肿块压迫尺神经的诊断。进行了手术探查,发现由于钙沉积的肿块效应导致明显的尺神经受压。对肿块进行了切除,并通过前移位对尺神经进行减压,结果令人满意。尽管此前已有皮肤钙化症导致肘管综合征的报道,但所有患者都有某种形式的钙调节异常。我们报告首例因特发性皮肤钙化症导致肘管处尺神经受压的病例。尽管钙沉积未完全切除,但对肿块进行切除并通过前移位对尺神经进行减压在我们的患者中取得了成功。