Large Tumoral Calcinosis in The Gluteal Region: A Case Report

Abstract

SUMMARYBackground. Tumoral calcinosis is a poorly understood phenomenon. It can be described as a syndrome of calcium deposits principally affecting the juxta-articular areas. It is a rare entity that has been poorly understood. Our aim is to highlight a special and unusual case of an 11-year-old with a large, relatively painless lump in her buttock.Clinical case. An 11-year-old girl of African descent presented to our Bone Tumour Unit after being referred by her local hospital. The girl presented with a large lump on the posterolateral aspect of the right buttock, measuring 15cm in diameter. Due to the delay in referral/diagnosis, tethering of the skin had progressed to necrosis, with a sinus discharging milky-white fluid. A MRI scan further characterised the lump as a densely calcified area within the gluteus maximus, extending to the subcutaneous tissue. The characteristic features of the calcified mass on the images led to the diagnosis of tumoral calcinosis. Laboratory test did not demonstrate any metabolic disturbances. Pathology reports further confirmed the diagnosis and the lump was successfully resected. There were no recurrences on follow-up.Conclusion. Several cases of tumoral calcinosis have been described in the literature; however, it remains a rare entity. Being aware of the possibility and having knowledge of tumoral calcinosis is paramount in preventing confusion and delay in diagnosis for patients and clinicians.

Tumoral calcinosis simulating sarcoma

“…Though the lesion does not infiltrate into surrounding normal tissues, but large-sized mass can cause compression symptoms and can lead to pressure necrosis of underlying tissues, and can also ulcerate the surface skin [9,10]. These large tumoral calcinosis may be mistaken clinically and at times radiologically as a malignant neoplasm like osteosarcoma, synovial sarcoma [8] as happened in the present case or with other calcium deposition conditions.…”

“…Phosphate lowering drugs can help in the complete resolution of small lesions in subtypes 2 and 3. While subtype 1 lesion and large size type 2 and 3 lesions need surgical intervention in the form of excision [9,10,16]. As our patient is categorized as subtype 1, surgical management is done.…”