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Soft Tissue Tumors

Infections, inflammation and hematomas

Tumoral calcinosis


Reviewer: Komal Arora, M.D. (see Reviewers page)
Revised: 3 April 2014, last major update July 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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Definition: large painless calcified masses in periarticular soft tissues, including elbows, hips, only rarely knees
● Also called calcium hydroxyapatite deposition in soft tissue, metastatic calcification
● Usage is imprecise - also refers to hereditary condition associated with massive periarticular calcification and any massive collection of periarticular calcification (Radiographics 2006;26:871)

Clinical description
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● Associated with trauma, renal failure, hyperparathyroidism, metastatic carcinoma, myeloma, scleroderma, hypermetabolic states, sarcoidosis
● Associated with mutations in fibroblast growth factor-23 gene and other genes (J Bone Joint Surg Am 2009;91:1190, OMIM #212900)
● Rarely is familial (Am J Surg Pathol 1993;17:788)

Laboratory:
● Elevated serum calcium, phosphate and Vitamin D
● Local recurrence common

Radiology description
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● Lobulated calcifications, separate from associated bone

Gross description
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● Large, multinodular, chalky masses

Micro description
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● Lobules of calcific material surrounded by histiocytic giant cells often containing small psammomatous calcifications

Micro images
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Calcification with foreign body inflammation

   
Contributed by John Irlam, D.O

Differential diagnosis
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● Dystrophic calcification: contains dead tissue that is not rapidly absorbed; associated with coagulation necrosis, caseous necrosis, fat necrosis

Additional references
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● Tumoral calcinosis like lesions (Am J Surg Pathol 2007;31:15)

End of Soft Tissue Tumors > Infections, inflammation and hematomas > Tumoral calcinosis


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