Gaint cell tumour of phalynx: have you seen it?

Giant cell tumors are rarely seen in the foot. Only 1-2% cases of GCT occur in the foot. They can cause a significant amount of pain and deformity due to their aggressive and recurrent nature whenever it occurs in foot. We present an unusual case of a giant cell tumor of proximal phalynx of middle toe of left foot. 26 year old male came with complaints of pain and swelling over the middle toe of left foot since 6 months. Clinical and radiological features showed features consistent with GCT. Foot Function Index revealed a) Pain scale: 29 / 50 = 58%, b) Disability scale: 56 / 90 = 62%, c) Activity limitation scale: 8 / 30 = 27%. Authors performed enbloc resection with ray amputation of 3rd toe. Histopathological examination of excised specimen revealed classic findings of mononuclear cells with interspersed fibro-collagenous strands and numerous multinucleated osteoclast-like giant cells which confirmed our diagnosis. Patient was serially followed up and at 6 months followup, there were no signs of recurrence with markedly improved foot function index.

Hyperphosphatemic tumoral calcinosis: a rare differential of periarticular swelling

Tumour calcinosis is a rare clinical and histopathological syndrome characterised by deposition of calcium deposits in different periarticular soft tissue regions of the body. It mainly manifest in childhood/ adolescence as a painless, firm to hard tumour like mass around the joints. Most common regions involved: Shoulder, elbow and hip. An 18 year old male patient presented to the opd with a history of pain and swelling over his left hip since 2 months. On examination, there was a diffuse tender swelling over the left greater trochanter, skin over the swelling was normal with no discharge, no dilated/ engorged veins. Range of motion of left hip was normal, no limb length discrepancies. X-ray: Showed a well define calcified mass over the greater trochanter with no osseous involvement. MRI revealed an encapsulated hypointense mass present posterior to the greater trochanter, mostly in the muscular plane. Lab findings revealed mild hyperphosphetemia. An aspirate from the swelling showed casseousmaterial. En mass removal was done and sent for biopsy. Biopsy showed features suggestive of tumoral calcinosis. Tumoral calcinosis is a distinct clinico-radiopathological entity characterised by soft tissue periarticular calcinosis which mimics a true neoplasm, associated with elevated levels of serum phosphate. It is an extremely rare condition which is seen in the adolescence and requires more studies regarding the surgical and medical management of the same.