Saeed Alam, Nasira Bhatti, Umar Farooq, Tasneem Akhtar Bhatti.
Tumoral Calcinosis - A Case Report.
J Rawal Med Coll Jan ;4(1-2):60-2.

Introduction: Tumoral calcinosis is an infrequent condition whose etiology is poorly understood. Calcification in the sub -cutaneous tissues neighbouring the large joints can affect all age groups although more commonly before the age of twenty years. Tumoral calcinosis is a poorly defined disease. In its classic form it consists of multiple large foci of benign mineralization in the soft tissues adjacent to bone near large joints. Patients are generally of African descent and are adolescents or young adults at presentation. Both metabolic and traumatic etiologies have been proposed. It is sometimes seen as inherited disease both as an autosomal recessive or dominant condition, thought to be associated with abnormality of calcium and phosphorous metabolism. Case Report: An 18 year old male patient presented with swelling around large joints. X-ray appearances revealed irregularly placed lobulated high density shadows. Routine investigations were as follow: Blood picture showed relative leucocytosis with a total count of 20,000 and 89% polymorphs. Renal Function Tests were within normal range. (Urea 24mg/dl. Creatinine 0.6mg/dl and Uric acid 4.3mg/dl) Serum alkaline phosphatase levels were raised to 463u/L (n39-117u/L) Parathyroid hormone levels were 21pmol/L (n3O-90pmol/L). Thyroid function tests were within normal range. FNA performed showed acellular material and biopsy was suggested .A previously performed biopsy elsewhere suggested a diagnosis of Tissue Calcinosis. Fresh biopsy specimen on histological examination revealed marked calcification with prominent rimming of histiocytes and osteoclast type of multinucleate giant cells.

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