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Semin Musculoskelet Radiol 2002; 06(4): 331-340
DOI: 10.1055/s-2002-36732
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Tumoral Calcinosis: 12 Years Later

Salutario Martinez
  • Department of Musculoskeletal Radiology, Duke University Medical Center, Durham, North Carolina
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Publication Date:
22 January 2003 (online)

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ABSTRACT

During the last 12 years, tumoral calcinosis (TC) has become an entity that is better understood by radiologists, clinicians, and pathologists. Several aspects of TC are well documented by the scientific community, although the most important, etiology, remains an enigma. As a consequence, the treatment of TC continues to be symptomatic. Imaging continues to be the best method for diagnosis, assessing extension, evaluating complications, monitoring treatment, and selecting patients for surgical excision. Investigators from different countries are reporting the most elusive component of TC: calcific myelitis. New systemic and cerebrovascular complications, even in the young, have been described recently. Similarly, ocular manifestation, which had not been reported previously, is well described in the recent literature. A few, poorly documented reports are confounding TC myelitis with osteomyelitis and TC periarticular soft tissue masses with tumoral calcium pyrophosphate dihydrate (CPPD) of the temporomandibular joint and spine. Advances in the clinical arena have resulted in a new approach and classification of several clinical forms of TC. Most of the recent literature has been related to the histopathology of TC. A new view of the old "traumatic theory" suggests microtrauma of connective tissues around the joints, causing bleeding and the formation of rudimentary bursae as the initial event. Perhaps, in the near future, research will define at the genetic and molecular levels the etiology and pathophysiology that will allow the treatment and prevention of TC.

KEYWORD

Tumoral calcinosis - imaging - bursa - myelitis

REFERENCES

  • 1 Inclan A, Leon P, Gomez C M. Tumoral calcinosis.  JAMA . 1943;  121 490-495
    PubMedSearch in Google Scholar
  • 2 Giard A M. Sur La Calcification Hibernale. Compes Rend des Seanes de la Soc. de Biologie So 1898 : 1013-1015
    Search in Google Scholar
  • 3 Duret M H. Tumous multiples et singulieres des bourses sereuses (endotheliomes, peutotre d'origine parasitarire).  Bull Mem Soc Anat Paris . 1899;  74 725-733
    PubMedSearch in Google Scholar
  • 4 Martinez S, Vogler III B J, Harrelson J M, Lyles K W. Imaging of tumoral calcinosis: new observations.  Radiology . 1990;  174 215-222
    CrossrefPubMedSearch in Google Scholar
  • 5 Smack D, Norton S A, Fitzpatrick J E. Proposal for a pathogenesis-based classification of tumoral calcinosis.  Int J Dermatol . 1996;  35 265-271
    CrossrefPubMedSearch in Google Scholar
  • 6 Cofan F, Garcia S, Combalia A. Uremic tumoral calcinosis in patients receiving longterm hemodialysis therapy.  J Rheumatol . 1999;  26 379-385
    PubMedSearch in Google Scholar
  • 7 Steinbach L S, Tepper E. Tumoral calcinosis caused by underlying renal disease.  AJR Am J Roentgenol . 1997;  168 1621
    PubMedSearch in Google Scholar
  • 8 Pakasa N M, Kalengayi R M. Tumoral calcinosis: a clinicopathological study of 111 cases with emphasis on the earliest changes.  Histopathology . 1997;  31 18-24
    CrossrefPubMedSearch in Google Scholar
  • 9 Slavin R E, Wen J, Kumar D, Evans E B. Familial tumoral calcinosis. A clinical, histopathologic, and ultrastructural study with an analysis of its calcifying process and pathogenesis.  Am J Surg Pathol . 1993;  17 788-802
    CrossrefPubMedSearch in Google Scholar
  • 10 Burkes Jr J E, Lyles K W, Dolan E A, Giammara B, Hanker J. Dental lesions in tumoral calcinosis.  J Oral Pathol Med . 1991;  20 222-227
    PubMedSearch in Google Scholar
  • 11 Malhem R E, Khachadurian A K. Cortical hyperostosis with hyperphosphatemia: a new syndrome.  J Pediatr . 1970;  77 986-990
    PubMedSearch in Google Scholar
  • 12 Ballina-Garcia F J, Queiro-Silva R, Fernandez-Vega F. Diaphysitis in tumoral calcinosis syndrome.  J Rheumatol . 1996;  23 2148-2151
    PubMedSearch in Google Scholar
  • 13 Blay P, Fernandez-Martinez J M, Diaz-Lopez B. Vertebral involvement in hyperphosphatemic tumoral calcinosis.  Bone . 2001;  28 316-318
    CrossrefPubMedSearch in Google Scholar
  • 14 Majeed S A. Chronic recurrent multifocal osteomyelitis associated with tumoral calcinosis.  J Bone Joint Surg Br . 1994;  76 325-327
    PubMedSearch in Google Scholar
  • 15 Thurmon T F, Jackson J. Tumoral calcinosis and Engelmann disease.  Birth Defects . 1976;  12 321-325
    PubMedSearch in Google Scholar
  • 16 McGuinness F E. Hyperphosphataemic tumoral calcinosis in Bedouin Arabs-clinical and radiological features.  Clin Radiol . 1995;  50 259-264
    CrossrefPubMedSearch in Google Scholar
  • 17 Adams W M, Laitt R D, Davies M, O'Donovan D G. Familial tumoral calcinosis: association with cerebral and peripheral aneurysm formation.  Neuroradiology . 1999;  41 351-355
    CrossrefPubMedSearch in Google Scholar
  • 18 Beck D A, Gray L, Lyles K W. Dementia associated with hyperphosphatemic tumoral calcinosis.  Clin Neurol Neurosurg . 1998;  100 121-125
    CrossrefPubMedSearch in Google Scholar
  • 19 Ghanchi F, Ramsay A, Coupland S, Barr D, Lee W R. Ocular tumoral calcinosis. A clinicopathologic study [erratum appears in Arch Ophthalmol 1996;114:1338].  Arch Ophthalmol . 1996;  114 341-345
    PubMedSearch in Google Scholar
  • 20 Dinur D, Klein Y, Stalnikowiez R, Brezis M. Systemic amyloidosis secondary to tumoral calcinosis.  Nephron . 1991;  59 525-526
    PubMedSearch in Google Scholar
  • 21 Steinbach L S, Johnston J O, Tepper E F, Honda G D, Martel W. Tumoral calcinosis radiologic-pathologic correlation.  Skeletal Radiol . 1995;  24 573-578
    PubMedSearch in Google Scholar
  • 22 Quarles L D, Murphy G, Econs M J. Uremic tumoral calcinosis: preliminary observations suggesting an association with aberrant vitamin D homeostasis.  Am J Kidney Dis . 1991;  18 706-710
    PubMedSearch in Google Scholar
  • 23 Tezelman S, Siperstein A E, Duh O Y, Clark O H. Tumoral calcinosis: controversies in the etiology and alternatives in the treatment.  Arch Surg . 1993;  128 737-744
    PubMedSearch in Google Scholar
  • 24 Yamakawa K, Iwasaki H, Ohjii Y. Tumoral calcium pyrophosphate dihydrate crystal deposition disease. A clinicopathologic analysis of five cases.  Pathol Res Pract . 2001;  197 499-506
    PubMedSearch in Google Scholar
  • 25 Luisiri P, Blair J, Ellman M H. Calcium pyrophosphate dihydrate deposition disease presenting as tumoral calcinosis (periarticular pseudogout).  J Rheumatol . 1996;  23 1647-1650
    PubMedSearch in Google Scholar
  • 26 Kokubun S, Ozawa H, Sakurai M, Tanaka Y. Tumoral calcinosis in the upper cervical spine: a case report.  Spine . 1996;  21 249-252
    CrossrefPubMedSearch in Google Scholar
  • 27 Matsukado K, Amano T, Itou O, Yuhi F, Nagata S. Tumoral calcinosis in the upper cervical spine causing progressive radiculomyelopathy-case report.  Neurol Med Chir (Tokyo) . 2001;  41 411-414
    CrossrefPubMedSearch in Google Scholar
  • 28 Durant D M, Riley III H L, Burger P C, McCarthy E F. Tumoral calcinosis of the spine: a study of 21 cases.  Spine . 2001;  26 1673-1679
    CrossrefPubMedSearch in Google Scholar
  • 29 Sledz K, Ortiz O, Wax M, Bouquot J. Tumoral calcinosis of the temporomandibular joint: CT and MR findings.  Am J Neuroradiol . 1995;  16 782-785
    PubMedSearch in Google Scholar
  • 30 Yan C, Qiu W L. Bilateral discal tumoral calcinosis of the temporomandibular joint.  J Oral Maxillofac Surg . 2002;  60 315-318
    CrossrefPubMedSearch in Google Scholar
  • 31 Noyez J F, Murphree S M, Chen K. Tumoral calcinosis, a clinical report of eleven cases.  Acta Orthop Belg . 1993;  59 249-254
    PubMedSearch in Google Scholar
  • 32 Mozaffarian G, Lafferty F W, Pearson O H. Treatment of tumoral calcinosis with phosphorus deprivation.  Ann Intern Med . 1972;  77 741-745
    PubMedSearch in Google Scholar
  • 33 Davies M, Clements M R, Mawer E B, Freemont A J. Tumoral calcinosis: clinical and metabolic response to phosphate deprivation.  QJM . 1987;  242 493-503
    PubMedSearch in Google Scholar
  • 34 Gregosiewicz A, Warda E. Tumoral calcinosis: successful medical treatment.  J Bone Joint Surg . 1989;  71A 1244-1249
    PubMedSearch in Google Scholar