Retrospective Study of Seven Patients with Tumoral Calcinosis

Original Article | Volume 6 | Issue 2 | JBST May-August 2020 | Page 12-16 | Kshitij Manerikar, Abhijeet Salunke, Jaymin V. Shah, Mayur Kamani, Shashank Pandya. DOI: 10.13107/jbst.2020.v06i02.25

Author: Kshitij Manerikar[1], Abhijeet Salunke[1], Jaymin V. Shah[1], Mayur Kamani[1], Shashank Pandya[1]

[1]Department of Surgical Oncology, Gujarat Cancer Research and Institute, Ahmedabad, Gujarat, India.

Address of Correspondence
Dr. Kshitij Manerikar,
A-302, Divyadeep, Ram Mandir Road, TPS-3, Borivali West, Mumbai – 400 092, Maharashtra, India.


Introduction: Calcium deposition in the skin has been termed as calcinosis cutis. Tumoral calcinosis is idiopathic form of calcinosis cutis. Etiology of idiopathic calcinosis cutis is unknown. It is characterized by periarticular deposition of amorphous calcium salts around large joints. Our diligent search through literature could not find any consensus on the etiopathogenesis and treatment modalities for tumoral calcinosis.
Materials and Methods: A retrospective study of seven patients of tumoral calcinosis treated with complete surgical excision over a period of 1 year was done. Demographic details were compiled. Routine blood investigations were performed. All patients underwent radiographs and magnetic resonance imaging (MRI) scans of involved part. We did not perform computed tomography (CT) or bone scan in any of our patients. All seven patients underwent surgery and were followed up till 2 years.
Results: In our study, five were female and two were male patients ranging from 31 to 76 years. Size of swelling varied from 2 to 15 cm. Most common location was hip. Serum calcium, phosphorus, and alkaline phosphatase were normal in all patients. Radiographs showed well-outlined periarticular cluster of calcifications in the soft tissues around joint. MRI revealed round to oval multiple cystic lesions around the affected region, but not involving the joint.
Conclusion: Tumoral calcinosis is always the diagnosis of exclusion. It can be normophosphatemic or hypophosphatemic subtype. Large joints are more commonly affected. One can rely on radiographs for diagnosis. MRI for knowing exact location of lesion, its relationship with adjacent structures and planning of surgery is advocated. Complete surgical excision is the only optimum treatment of tumoral calcinosis.
Keywords: Amorphous calcium phosphate, hyperphosphatemia, X-ray film, hip joint, calcinosis, magnetic resonance imaging.

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How to Cite this article: Manerikar K, Salunke A, Shah JV, Kamani M, Pandya S | Retrospective Study of Seven Patients with Tumoral Calcinosis | Journal of  Bone and Soft Tissue Tumors | May-August 2020; 6(2): 12-16.

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Heterotopic Ossification Circumferentia Articularis (HOCA) of Hip Joint: A Case Series and Review of the Literature

Case Report | Volume 5 | Issue 2 | JBST May – August 2019 | Page 8-10| R Vaishya, A Goel, A K Agarwal, A Vaish. DOI: 10.13107/jbst.2019.v05i02.426

R Vaishya[1], A Goel[1], A K Agarwal[1], A Vaish[1]

[1]Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi, India.

Address of Correspondence
Dr. Amit Kumar Agarwal,
Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, New Delhi – 110 076,India.

Introduction: Heterotopic ossification (HO) is often described as the mature, lamellar bone formed in a non-osseous tissue. This new bone formation usually occurs between muscle planes or between muscle and joint capsule. When it surrounds a joint circumferentially, it is known as (HO) Heterotopic Ossification circumferentia articular is circumferential articularis (HOCA). HOCA of the knee has been described earlier in the literature, but this term has never been described for the hip joint in the literature.
Case Presentation: We present a case series of two such patients having HOCA of hip joints. In both the cases, there was a history of brain injury and prolonged intubation, which seems the most likely predisposing factors in the causation of HOCA in these hips.
Conclusion: We believe that in our patient, the responsible factors for the causation of HOCA could be myriad of factors such as prolonged intensive care unit (ICU) stay with mechanical ventilation and hypoxia, long-standing immobilization, and hypomobility with incomplete flaccid paralysis. The surgical excision is quite challenging, extensive and is not advisable in most cases, and they respond symptomatically to conservative methods including analgesics, bisphosphonates, physiotherapy, and radiation.
Keywords: Heterotopic ossification circumferentia articularis, hip joint, neurological injury,

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Dr. R Vaishya Dr. A Goel Dr. A K agarwal Dr. A Vaish


How to Cite this article: Vaishya R, Goel A, Agarwal AK, Vaish A. Heterotopic Ossification Circumferentia Articularis of Hip Joint: A Case Series and Review of the Literature. Journal of Bone and Soft Tissue Tumors May-August 2019;5(2): 8-10.

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