Introduction
Tumoral calcinosis (TC) is a rare clinicopathological entity
characterized by the presence of calcified deposits in periarticular
soft tissue. The calcified deposits predominantly comprise of calcium
hydroxy apatite crystals and amorphous calcium
phosphate1. Clinically, they appear as a painless
slowly growing mass in the vicinity of large joints such as hips,
shoulder, and elbow 2, 3. However, it has also been
reported in other areas such as the neck, arms, hands, spine, legs, and
feet 3. The progressive growth of the mass may result
in pain, nerve compression, and functional impairment4. The overlying skin is usually intact; however,
long-standing lesions may lead to skin ulceration and sinus tract
formation with chalk white drainage 2.
The diagnosis of TC is based on clinical and imaging findings. It has a
characteristic radiographic appearance of multilobulated calcification
in periarticular soft tissues, commonly on the extensor side of the
articulation. Radiolucent lines separate the lobules (fibrous septa)5, 6. Ultrasound can be used to examine lesions,
especially with minimal calcification, appearing as heterogeneous
multiloculated mass with multiple cavities separated by hyperechoic thin
septa. Color doppler may detect blood flow in some of these septa. MRI
is superior to CT scan in detecting the extent of the lesions and their
relationship with surrounding structures 6. However,
histopathological examination is required for definitive diagnosis.
Treatment options include both medical and surgical intervention5, 7.
We present a case of tumoral calcinosis with peculiar presentation. A
case of 4-year-old female with tumoral calcinosis of the extensor
indicis proprius tendon on the right wrist.