Tumoral Calcinosis

Tumoral calcinosis is a term whose true meaning has been lost over the years. It is now a stand-in for any kind of periarticular calcification. However, it has a specific definition: a hereditary disease of phosphate metabolic dysfunction that leads to the formation of characteristic lobulated, well-demarcated soft tissue calcifications distributed most commonly around the extensor surface of large joints. The sedimentation sign may be seen on CT and upright radiographs when calcium layers dependently in cysts.

Many conditions that mimic tumoral calcinosis are mistakenly referred to by the same name. The most common mimicker is calcinosis of chronic renal failure, which is actually the case shown here. This is the most common cause of a periarticular calcified mass. Calcinosis of chronic renal failure is seen in about 1% of patients on hemodialysis. The cause is unknown, but is thought to be related to hyperparathyroidism. There is no radiologic or histologic difference between these lesions and the lesions of tumoral calcinosis.

Specific dental abnormalities can be seen in patients with tumoral calcinosis, including short bulbous roots of teeth, pulp stones, and partial obliteration of the pulp cavity.

References

• Burkes EJ Jr, Lyles KW, Dolan EA, Giammara B, Hanker J. Dental lesions in tumoral calcinosis. J Oral Pathol Med. 1991 May;20(5):222-7.
• Hug I, Gunçaga J. Tumoral calcinosis with sedimentation sign. Br J Radiol. 1974 Oct;47(562):734-6.
• Olsen KM, Chew FS. Tumoral calcinosis: pearls, polemics, and alternative possibilities. Radiographics. 2006 May-Jun;26(3):871-85.