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Acral post-traumatic tumoral calcinosis in pregnancy: a case report

DOI: 10.1186/1752-1947-5-89

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We present the case of a 31-year-old pregnant Indian woman with a three-month history of painful swelling within the tip of her right middle finger following a superficial laceration. She was otherwise well and had normal serum calcium and phosphate levels. Plain radiography demonstrated a dense, lobulated cluster of calcified nodules within the soft tissues of the volar pulp space, consistent with a diagnosis of tumoral calcinosis. This diagnosis was confirmed on the basis of the histopathological examination following surgical excision.To the best of our knowledge, we present the only reported case of acral tumoral calcinosis within the finger, and the first description of its occurrence during pregnancy. We review the etiology, pathogenesis and treatment of tumoral calcinosis.Tumoral calcinosis is an uncommon pathological entity characterized by multiple circumscribed, tumor-like, calcified masses in peri-articular connective tissue. These lesions mainly comprise calcium hydroxyapatite crystals and amorphous calcium phosphate [1]. They were originally described by Giard in 1898 [2] and termed endotheliome calcifie. The term tumoral calcinosis was coined by Inclan et al. in 1943 [3], who described a familial condition characterized by normal serum calcium levels and elevated or normal serum phosphate levels. The term "tumoral calcinosis" has also been loosely used to describe secondary metastatic peri-articular calcification occurring in conditions such as renal insufficiency, hyperparathyroidism, hypervitaminosis D and milk-alkali syndrome. These disorders display an underlying abnormality of calcium and phosphorus homeostasis. In contrast, dystrophic tumoral calcinosis occurs as a result of damaged or devitalized soft tissues, but in the presence of normal biochemistry, for example, following trauma, infection, inflammation or neoplasia.The most frequent cause of tumoral calcinosis is chronic renal failure, with a reported prevalence of 0.5% to 1.2% in patients


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