Tumoral calcium pyrophosphate deposition disease

Abstract

A report of two patients in which a soft tissue mass, initially regarded as a malignant tumor, was shown to be the result of calcium pyrophosphate deposition disease. The first case, a woman aged 71 years, presented with a mass involving the right fifth finger. In the second case, also a woman aged 71 years, the lesion involved the tissues adjacent to the right hip. Each lesion consisted of a mass of highly cellular tissue containing deposits of calcium pyrophosphate dihydrate crystals. The clinical, radiological, and pathological features of the two cases are compared with those of seven similar cases reported in the literature.

Tumoral calcium pyrophosphate dihydrate deposition disease with bone destruction in the shoulder

“…There have been a few reports of CT findings on tumoral CPPD deposition disease (5,11,12) but none on cases in which the tumoral CPPD deposition was as large as in our patients. The CT findings in tumoral CPPD deposition that are usually reported show: a calcified mass with lobulated configuration; situated near a joint; causing pressure erosion and disruption of adjacent bony cortex; but not invading the joint space.…”

“…There has been only one report of a tumoral CPPD deposition of more than 10 cm in diameter (8), the site of which was around the acromioclavicular joint. Plain radiographic features of small tumoral CPPD depositions have been amply reported (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12), usually presenting as a monoarticular disease. Amorphous calcification around a joint and pressure erosion of adjacent bones are sometimes seen and plain radiography in our patients showed these characteristics.…”

Tumoral Calcinosis in the Upper Cervical Spine Causing Progressive Radiculomyelopathy. Case Report.

“…The treatment of choice is surgical removal of the lesion when small and amenable to total resection, because recurrence without total removal of the lesion has occurred in other locations. 17,20) If the total resection is impossible, clinical and radiographic follow up are essential to identify any recurrence.…”

Lesions of juxtacortical origin (surface lesions of bone)

“…10). The deposits consist of small crystals which can be identified by their rhomboid shape under polarized light with weakly positive birefringence [3,10,18]. Clinically, the patient presents with a firm nontender juxtacortical mass.…”