Tumoral calcinosis: a case report

An 11-year-old girl presented with a progressive swelling of the right elbow after a contusion. Radiography and magnetic resonance imaging showed a densely calcified lesion with no periosteal reaction or fracture. The underlying bone and muscles had normal signal intensity. A bone scan revealed increased uptake over the right elbow and the left buttock and acetabulum. Blood tests revealed no abnormality. As the mass progressively increased in size and malignancy could not be excluded, excision was performed 4 months after presentation. A lobulated, yellowish mass with a pseudo-capsule measuring 9x7x4 cm was excised. It was not attached to surrounding muscles, and some chalky, well-defined material emerged from the surface. Histological findings confirmed the diagnosis of tumoral calcinosis. The mass was transversed by fibrous septa with fibroblastic proliferation. Foreign body giant cells and histiocytic cells were found within the septa. There was no evidence of malignancy. Four months later, excision of the left elbow and buttock lesions was performed, and histology of both revealed the same diagnosis. At the 4-year follow-up, there was no recurrence.