Subscribe to RSS
DOI: 10.1055/s-2002-36732
Tumoral Calcinosis: 12 Years Later
Publication History
Publication Date:
22 January 2003 (online)
![](https://www.thieme-connect.de/media/smr/200204/lookinside/thumbnails/10.1055-s-2002-36732-1.jpg)
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
- 2 Giard A M. Sur La Calcification Hibernale. Compes Rend des Seanes de la Soc. de Biologie So 1898 : 1013-1015
- 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
- 4 Martinez S, Vogler III B J, Harrelson J M, Lyles K W. Imaging of tumoral calcinosis: new observations. Radiology . 1990; 174 215-222
- 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
- 6 Cofan F, Garcia S, Combalia A. Uremic tumoral calcinosis in patients receiving longterm hemodialysis therapy. J Rheumatol . 1999; 26 379-385
- 7 Steinbach L S, Tepper E. Tumoral calcinosis caused by underlying renal disease. AJR Am J Roentgenol . 1997; 168 1621
- 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
- 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
- 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
- 11 Malhem R E, Khachadurian A K. Cortical hyperostosis with hyperphosphatemia: a new syndrome. J Pediatr . 1970; 77 986-990
- 12 Ballina-Garcia F J, Queiro-Silva R, Fernandez-Vega F. Diaphysitis in tumoral calcinosis syndrome. J Rheumatol . 1996; 23 2148-2151
- 13 Blay P, Fernandez-Martinez J M, Diaz-Lopez B. Vertebral involvement in hyperphosphatemic tumoral calcinosis. Bone . 2001; 28 316-318
- 14 Majeed S A. Chronic recurrent multifocal osteomyelitis associated with tumoral calcinosis. J Bone Joint Surg Br . 1994; 76 325-327
- 15 Thurmon T F, Jackson J. Tumoral calcinosis and Engelmann disease. Birth Defects . 1976; 12 321-325
- 16 McGuinness F E. Hyperphosphataemic tumoral calcinosis in Bedouin Arabs-clinical and radiological features. Clin Radiol . 1995; 50 259-264
- 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
- 18 Beck D A, Gray L, Lyles K W. Dementia associated with hyperphosphatemic tumoral calcinosis. Clin Neurol Neurosurg . 1998; 100 121-125
- 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
- 20 Dinur D, Klein Y, Stalnikowiez R, Brezis M. Systemic amyloidosis secondary to tumoral calcinosis. Nephron . 1991; 59 525-526
- 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
- 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
- 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
- 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
- 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
- 26 Kokubun S, Ozawa H, Sakurai M, Tanaka Y. Tumoral calcinosis in the upper cervical spine: a case report. Spine . 1996; 21 249-252
- 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
- 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
- 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
- 30 Yan C, Qiu W L. Bilateral discal tumoral calcinosis of the temporomandibular joint. J Oral Maxillofac Surg . 2002; 60 315-318
- 31 Noyez J F, Murphree S M, Chen K. Tumoral calcinosis, a clinical report of eleven cases. Acta Orthop Belg . 1993; 59 249-254
- 32 Mozaffarian G, Lafferty F W, Pearson O H. Treatment of tumoral calcinosis with phosphorus deprivation. Ann Intern Med . 1972; 77 741-745
- 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
- 34 Gregosiewicz A, Warda E. Tumoral calcinosis: successful medical treatment. J Bone Joint Surg . 1989; 71A 1244-1249