Tumoral calcinosis in bilateral facet joints of the lumbar spine in scleroderma

Abstract

<jats:p>✓Tumoral calcinosis commonly occurs in the articular soft tissues of the extremities but rarely in the spine. The authors performed surgery to treat lumbar tumoral calcinosis in a patient with scleroderma, in whom symptoms of neurological dysfunction had manifested.</jats:p> <jats:p>This 49-year-old woman presented with low-back pain and gait disturbance. Seven years before presentation, scleroderma had been diagnosed, and the patient had received medical treatment ever since. Imaging revealed tumoral calcinosis centered at the bilateral facet joints between L-3 and L-4, marked stenosis of the spinal canal, L-3 spondylolisthesis, and intervertebral instability. Surgery was performed to excise the lesion en bloc. After neural decompression, posterolateral fusion and pedicle screw fixation were undertaken. Symptoms improved after surgery.</jats:p> <jats:p>In this case, the underlying scleroderma that predisposes to calcinosis and facet joint degeneration due to lumbar spondylolisthesis were probably factors leading to the development of tumoral calcinosis in the lumbar spine.</jats:p>

Paraspinal and intraspinal calcinosis: frequent complications in patients with systemic sclerosis

“…By contrast, spinal calcinosis has been the subject of limited reports,1 2 3 4 5 6 7 and its prevalence and disease–phenotype associations have not been discussed.…”

Tumoral Calcinosis of Thoracic Spine Associated with Systemic Sclerosis: Figure 1.

“…Most reports have described that the calcific materials, proven to be hydroxyapatite by pathological analysis 1 , were located at the cervical spine 2-6 and lumbar spine 1,7 . Thoracic spine involvement was demonstrated in only one study 8 .…”

“…By contrast, spinal calcinosis has been the subject of only limited reports [1][2][3][4][5][6][7][8] . We describe a woman with the diffuse cutaneous form of SSc who presented with serious neurological symptoms, including a rapidly progressive course of motor and sensory disturbance.…”

Tumoral calcinosis and epidural lipomatosis of the lumbar spine

“…Tumoral calcinosis involving the lumbar spine is rare; to our knowledge, only 9 studies on lumbar tumoral calcinosis have been reported in the literature (1,2,7,8,9,11,13,14,15). The lesions involved the vertebral bodies, facet joints, dura, and filum terminale (1,2,8,9).…”

“…The lesions involved the vertebral bodies, facet joints, dura, and filum terminale (1,2,8,9). Scleroderma, systemic sclerosis, and CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome may be the underlying disorders (7,9,12,14).…”