Tumoral Calcinosis of Thoracic Spine Associated with Systemic Sclerosis: Figure 1.

Ogawa, Takehiko; Ogura, Takeshi; Hayashi, Norihide; Hirata, A.

doi:10.3899/jrheum.090274

Cited by 16 publications

(16 citation statements)

References 6 publications

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“…Soft tissue calcifications are historically divided into four types: dystrophic, tumorous, metastatic, and idiopathic. [ 4 5 6 ] Serum levels of calcium and phosphorus in patients with dystrophic calcinosis, including our patient, are usually within normal limits. There is a fifth type of calcinosis called calciphylaxis because of the presence of a vitamin D or parathyroid hormone playing the role of a “calcifer.”[ 5 ]…”

Section: Discussionmentioning

confidence: 77%

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Intraspinal calcinosis mimicking intervertebral disc extrusion: A clinical and surgical case report

Maraković¹,

Marinović²,

Jeleč³

et al. 2018

Surg Neurol Int

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Background:Subcutaneous calcinosis is a well-recognized manifestation of systemic sclerosis that usually involves multiple pressure points and may also be found in the paraspinal or intraspinal regions. In this case, intraspinal calcinosis uniquely led to a severe neurological deficit.Case Description:A patient with severe systemic sclerosis/calcinosis exhibited left greater than right lower extremity radiculopathy attributed to intraspinal left-sided L4-L5 calcinosis. On examination, the patient exhibited bilateral positive Lasegue signs, distal lower extremity weakness (left greater than right), and bilaterally decreased Achilles responses. When the magnetic resonance imaging (MRI) revealed a significant intracanalicular mass on the left side at the L4-L5 level, the patient underwent a left-sided L4-L5 decompressive laminectomy. The MRI scan 5 years later revealed no recurrence of the calcinosis, and the patient had no residual neurological deficit.Conclusions:Spinal calcinosis rarely involves the lumbar spinal canal. Here, a patient with a large left-sided L4-L5 focus of intraspinal calcinosis, mimicking a disc herniation, required a laminectomy to resect the lesion. Lumbar calcinosis should be radiologically evaluated utilizing using X-ray, MRI, and computed tomography studies to adequately document the pathology. Patients, when symptomatic, may require surgical decompression and excision of these lesions.

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Section: Discussionmentioning

confidence: 77%

“…[ 3 7 11 ] In some studies, the most common sites for spinal calcinosis are the cervical followed by the thoracic spine, and very rarely, the lumbar spine; other studies demonstrate calcinosis commonly involving the cervical or lumbar regions. [ 3 4 6 8 11 ]…”

Section: Discussionmentioning

confidence: 99%

Intraspinal calcinosis mimicking intervertebral disc extrusion: A clinical and surgical case report

Maraković¹,

Marinović²,

Jeleč³

et al. 2018

Surg Neurol Int

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“…Axial lesions generally remained undetected, being observed at the onset of a dramatic clinical event such as a deficit due to nerve root or medullary compression, in some cases justifying emergency surgery, as was observed in one of our patients. Axial calcification is rarely described in the literature, being reported in a few cases where cervical lesions predominated (80% of cases), [ 15 – 17 , 19 , 22 – 27 , 30 ] followed by lumbar (15% of cases) [ 17 , 19 , 22 ] and lastly thoracic in 5% of cases only. [ 30 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 14 – 16 , 18 , 21 – 28 ] The lumbar spine was less often affected, [ 17 , 19 , 22 , 29 ] and the thoracic spine even more rarely. [ 30 ] In 2009, Ogawa et al showed, in a series of 41 SSc patients, a 58.5% prevalence of dorsal intraspinal and paraspinal calcifications, of which 29% were observed to be intracanal on thoracic computer tomography scans (CT-scans) during follow-up. Moreover, a relationship was found between the presence of these calcifications and Raynauds syndrome, calcinosis cutis and digital ulcerations.…”

Section: Introductionmentioning

confidence: 99%

Relationship between calcifications and structural lesions on hand radiography and axial calcifications on CT-scan

et al. 2020

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The objectives of this study were to describe the prevalence and characteristics of radiographic lesions of the hands, and calcifications of the spine on computer tomography scans (CT-scans), and to investigate the relationships between radiographic and CT-scan abnormalities and clinical features in a population of patients with systemic sclerosis (SSc). Subjects underwent X-ray examination of the hands, and thoracic or thoraco-abdominal and pelvic CT scan or lumbar CT scan in the year. Structural lesions on hand X ray was scored and spinal calcifications were evaluated in the anterior, intracanal and posterior segments. Intra and inter-reliability was tested for radiography and CT- scan. Prognostic factors considered were interstitial pulmonary lesions on the CT scan, pulmonary arterial hypertension (PAH) and death. This study involved 77 SSc patients, 58 (75%) with limited cutaneous SSc (lcSSc) and 19 (25%) with diffuse SSc (dSSc). The prevalences of radiographic lesions of the hand were 28.6% for periarticular calcifications and 26% for calcinosis. On CT scan, 64 (83%) patients exhibited at least 1 calcification. Spine calcifications were depicted in 80.5%, 27.3%, and 35.1% at the anterior, intracanal and posterior segments respectively. Calcifications were mainly localized on thoracic spine. Inter reader reliabilities were good for hands and moderate for spine respectively. Spine calcifications and periarticular calcifications in the hands were associated ( P = .012). Calcinosis in the hands was related to PAH ( P = .02). Posterior calcification segment and foraminal calcifications were associated with interstitial lung disease (ILD) ( P = .029) and death ( P = .001). More than 80% of systemic sclerosis patients presented spine calcifications. A significant association between hands and spinal calcifications were confirmed and some localization in the posterior segment considered as a bad prognostic factor.

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“…Analysis of the literature revealed 41 cases of TC of the spine reported between 1952 and 2011. [1][2][3][4][5][6][7][8][9][10][11][12][13][15][16][17][20][21][22][23] There were 22 cases (54%) of spinal TC in female and 19 (46%) in male patients. The mean age at diagnosis was 55 years, with females being diagnosed at a slightly earlier age (mean 53.3 years, range 12-71 years) than males, who have been diagnosed at a mean age of 56.05 years (range 17-90 years).…”

Section: Discussionmentioning

confidence: 99%

Tumoral calcinosis presenting as a deformity of the thoracic spine

Kalani

Martirosyan

Little

et al. 2011

PED

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The authors describe a rare case of tumoral calcinosis (TC) of the thoracic spine in a 13-year-old boy with thoracic scoliosis. The patient presented with a 2-year history of back pain. He had no personal or family history of bone disease, deformity, or malignancy. Magnetic resonance imaging revealed a heterogeneously enhancing mass involving the T-7 vertebral body and the left pedicle. Computed tomography findings suggested that the mass was calcified and that this had resulted in scalloping of the vertebral body. The lesion was resected completely by using a left T-7 costotransversectomy and corpectomy. The deformity was corrected with placement of a vertebral body cage and pedicle screw fixation from T-5 to T-9. Pathological analysis of the mass demonstrated dystrophic calcification with marked hypercellularity and immunostaining consistent with TC. This represents the third reported case of vertebral TC in the pediatric population. Pediatric neurosurgeons should be familiar with lesions such as TC, which may be encountered in the elderly and in hemodialysis-dependent populations, and may not always require aggressive resection.

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Tumoral Calcinosis of Thoracic Spine Associated with Systemic Sclerosis: Figure 1.

Cited by 16 publications

References 6 publications

Intraspinal calcinosis mimicking intervertebral disc extrusion: A clinical and surgical case report

Intraspinal calcinosis mimicking intervertebral disc extrusion: A clinical and surgical case report

Relationship between calcifications and structural lesions on hand radiography and axial calcifications on CT-scan

Tumoral calcinosis presenting as a deformity of the thoracic spine

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