Scrotal calcinosis, dystrophic or idiopathic, does it matter? A case report

@#Scrotal calcinosis is a rare condition with controversy surrounding its unclear etiopathogenesis. Several schools of thought have emerged from recent publications supported by histological findings seen in the respective cases reported. The recommendation of surgery as management, and its outcome, however, have remained the same throughout history. This paper reports a 36-year-old male who presented with gradually progressing multiple pruritic nodules over the scrotum who underwent wide excision with favorable outcome on follow up. Histological examination confirmed the diagnosis of scrotal calcinosis and showed evidence of intact epidermoid cysts that have undergone dystrophic calcification.

A case of dystrophic calcification in the masseter muscle / 대한악안면성형재건외과학회지

BACKGROUND: Dystrophic calcification can occur in any soft tissue with the absence of a systemic mineral imbalance and is often associated with trauma, infection, or inflammation. It is easily found in the site of the heart and skeletal muscles and rarely appears in the head and neck area. CASE REPORT: We present a rare case of multiple calcified masses in the left masseter muscle of a 26-year-old female with a history of trauma in the area. In computed tomography, multiple radiopaque masses were observed inside the left masseter muscle and blood test results were normal. The calcified masses were diagnosed as dystrophic calcification and removed by surgery without any complications. CONCLUSION: Different types of calcifications may occur in the cheek area, and they need to be distinguished from dystrophic calcification. Thorough clinical examination and history taking is required together with blood testing and radiographic examinations.

Mineralized deposits in the uterus of a pig without pregnancy loss

Herein, we describe a case of uterine calcification in the uterus of a pig without pregnancy loss. The recipient underwent cloned embryo transfer and Cesarean section for safe delivery of cloned piglets. During the Cesarean section, 4 white, star-like, (2 × 2 × 2) cm, calcified structures were found within the endometrial cavity. Despite dystrophic calcification around the placenta, healthy cloned piglets were produced successfully. To our knowledge, this is the first reported case of dystrophic calcification occurring within the uterus in a pregnant pig.

Peripheral Ameloblastoma with Dystrophic Calcification: An Unusual Feature in Non-Calcifying Odontogenic Tumors

Peripheral ameloblastoma is a rare extraosseous counterpart of central ameloblastoma that occurs in soft tissues and may cause bone crest resorption. This study reports a peripheral ameloblastoma on the buccal gingiva of a 56-year-old man, which presented extensive squamous metaplasia areas, keratinization and dystrophic calcifications in the neoplastic islands. It is emphasized the need of a detailed imaging study and a long follow-up period to exclude bone involvement whenever peripheral ameloblastoma diagnosis is considered.

Ameloblastoma periférico é a contraparte rara extraóssea do ameloblastoma central, que ocorre em tecidos moles e pode causar reabsorção da crista óssea. Este estudo reporta um ameloblastoma periférico localizado na gengiva vestibular de um homem de 56 anos de idade, que apresentava extensas áreas de metaplasia escamosa, queratinização e calcificação distrófica dentro das ilhas neoplásicas. É enfatizada a necessidade de um estudo de imagem detalhado e acompanhamento prolongado para excluir envolvimento ósseo sempre que o diagnóstico de ameloblastoma periférico for considerado.

Can Large Dystrophic Calcifications in Breast Guarantee Benignity?: A Case Report

Dystrophic calcifications themselves in the breast are classified as typically benign according to the Breast Imaging Reporting and Data System. However, we experienced a patient with invasive ductal carcinoma surrounding large dystrophic calcifications that could be regarded as long-standing benign conditions such as fat necrosis or hematoma. A 61-year-old woman presented with two large dystrophic calcifications within an irregular mass in the right upper outer breast on mammography. Ultrasonography revealed an irregular mass with dense calcifications showing strong posterior acoustic shadowing. On contrast enhanced magnetic resonance imaging, an irregular mass showed a persistent enhancement pattern and high signal intensity on a diffusion weighted image with non-enhancing areas corresponding to the calcifications. No abnormal uptake was observed on Tc-99m methylene diphosphonate bone scan. Invasive ductal carcinoma was observed on ultrasonography-guided core needle biopsy. In this case, we conclude that typical dystrophic calcifications within a breast mass cannot guarantee a benign diagnosis if the imaging characteristics of the mass are suspicious.

Peripheral ossifying fibroma: A clinical and histological evaluation of 51 cases.

The present retrospective study was carried out to investigate the clinical and histological features of 51 cases of peripheral ossifying fibroma (POF). The clinical information such as age, sex, location, color of the lesion, pedunculated/ sessile was recorded. The lesion was found more frequently in females (62.75%) and 2nd decade. It had a predilection for the maxillary gingiva (68.63%) and the incisor/cuspid region (72.55%). The average age of occurrence was 38.5 years. Histologically, the surface epithelium was ulcerated in 15(29.41%) cases and in the rest, it was non-ulcerated. The lesion exhibited highly cellular fibroblastic tissue in 12(23.53%) cases, and in the remaining cases it showed more fibrous tissue. Mineralized products in the form of trabeculae of woven and/ or lamellar bone (61%), cementum like material (12%) and dystrophic calcification (27%) were noticed.

Calcifying Lupus panniculitis in a patient without manifestations of systemic lupus Erythematosus / Paniculitis Lúpica calcificante en un paciente sin manifestaciones de lupus eritematoso sistémico

Lupus panniculitis or lupus profundus is a variant of lupus Erythematosus cutaneous that primarily affects subcutaneous tissue. Clinically, it is characterized by one or several firm subcutaneous nodules and/or plaques with or without overlying epidermal changes. It is reported to occur with a frequency of 2-3% in patients with Systemic Lupus Erythematosus (SLE). Between 10 and 50 percent of patients with lupus panniculitis will have or eventually develop Systemic Lupus Erythematosus. In nearly all cases there are deep, erythematosus plaques and nodules, and some of them ulcers, which usually involve the proximal extremities, trunk, breasts, buttocks, and face. These lesions may be tender and painful and frequently heal with atrophy and scaring, turning as a chronic condition and subsequently heal with disfigurement. We describe a patient who suffers from lupus panniculitis with no association to SLE symptoms and complicated by several progressive and disabling cutaneous lesions.

La paniculitis lúpica o también llamada lupus profundus es una variante del lupus eritematoso cutáneo que afecta el tejido celular subcutáneo. Se caracteriza clínicamente por uno o varios nódulos subcutáneos que son firmes y/o placa con o sin cambios epidérmicos. Se ha informado su frecuencia en 2% a 3% de casos de Lupus eritematoso sistémico. Entre el 10 al 50% de los casos de paniculitis lúpica va a desarrollar lupus eritematoso sistémico. En casi todos los casos hay placas eritematosas y/o nódulos que en algunos casos se ulceran y que usualmente están localizados en las áreas proximales de las extremidades, tronco, mamas, nalgas y la cara. Estas lesiones pueden ser clínicamente dolorosas y sensibles a la presión y frecuentemente cicatrizan con desfiguración del área circundante. Describimos un paciente que padece de paniculitis lúpica sin asociación de lupus eritematoso sistémico y que se complicó con varias lesiones cutáneas progresivas y discapacitantes.

Dystrophic Calcification in the Epidural and Extraforaminal Space Caused by Repetitive Triamcinolone Acetonide Injections

The authors report a case of epidural and extraforaminal calcification caused by repetitive triamcinolone acetonide injections. A 66-year-old woman was admitted presenting with lower extremity weakness and radiating pain in her left leg. Ten months before admission, the patient was diagnosed as having an L4-5 spinal stenosis and underwent anterior lumbar interbody fusion followed by posterior fixation. Her symptoms had been sustained and she did not respond to transforaminal steroid injections. Repetitive injections (10 times) had been performed on the L4-5 level for six months. She had been taking bisphosphonate as an antiresorptive agent for ten months after surgery. Calcification in the ventral epidural and extraforaminal space was detected. The gritty particles were removed during decompressive surgery and these were proven to be a dystrophic calcification. The patient recovered from weakness and radiating leg pain. Repetitive triamcinolone acetonide injections after discectomy may be the cause of dystrophic calcification not only in the degenerated residual disc, but also in the posterior longitudinal ligament. Possible mechanisms may include the toxicity of preservatives and the insolubility of triamcinolone acetonide. We should consider that repetitive triamcinolone injections in the postdisectomy state may cause intraspinal ossification and calcification.

Two Cases of Calcinosis Cutis Combined with Rheumatologic Disease / 대한류마티스학회지

The calcinosis, dystrophic soft tissue calcification, occurs in damaged or devitalized tissues normal calcium/phosphorus metabolism. It is the subcutaneous tissues of connective tissues disease ?primarily systemic lupus erythematosus, scleroderma, or dermatomyositis - and may involve a relatively localized area. The calcinotic accumulations may result in muscle atrophy, joint contractures, and skin ulceration complicated by recurrent episodes of local inflammation and infection. Calcinosis may be the source of both pain and disability in connective tissue disease patients. While various therapeutic modality have been used, no treatment has convincingly prevented or reduced calcinosis. We report two cases of calcinosis cutis combined with rheumatic disease.

Dystrophic Calcification after a Local Injection of a Foreign Body into the Dorsum of the Hand

PURPOSE: Dystrophic calcification occurs in damaged or devitalized tissues in the presence of a normal calcium and phosphorus metabolism. There are many reports on dystrophic calcification caused by injections of various types of drugs. The aim of this report is to highlight the fact that dystrophic calcification can be caused by the injection of a foreign body for aesthetic augmentation. METHODS: This case report describes a patient presenting with dystrophic calcification caused by an injection of an unknown foreign body approximately 50 years ago. An 80-year-old man had localized cellulitis with swelling and ulceration on the dorsum of the left hand. The radiographs demonstrated a 5x3.5x1.7 cm lesion between the first and second metacarpal bones and a 5x2.5x1.5cm lesion in the hypothenar region. The laboratory data and physical examinations were generally within the normal limits. The microscopic examination revealed dead bone fragments and dense collagenous tissue with dystrophic calcification. RESULTS: After surgically removing the masses, the resulting defects were treated with an abdominal flap. The result was satisfactory in terms of symptoms and appearance. CONCLUSION: This case suggests that dystrophic calcification can be caused by an injection of a foreign body for aesthetic augmentation.

Dystrophic Calcification after a Local Injection of a Foreign Body into the Dorsum of the Hand

PURPOSE: Dystrophic calcification occurs in damaged or devitalized tissues in the presence of a normal calcium and phosphorus metabolism. There are many reports on dystrophic calcification caused by injections of various types of drugs. The aim of this report is to highlight the fact that dystrophic calcification can be caused by the injection of a foreign body for aesthetic augmentation. METHODS: This case report describes a patient presenting with dystrophic calcification caused by an injection of an unknown foreign body approximately 50 years ago. An 80-year-old man had localized cellulitis with swelling and ulceration on the dorsum of the left hand. The radiographs demonstrated a 5x3.5x1.7 cm lesion between the first and second metacarpal bones and a 5x2.5x1.5cm lesion in the hypothenar region. The laboratory data and physical examinations were generally within the normal limits. The microscopic examination revealed dead bone fragments and dense collagenous tissue with dystrophic calcification. RESULTS: After surgically removing the masses, the resulting defects were treated with an abdominal flap. The result was satisfactory in terms of symptoms and appearance. CONCLUSION: This case suggests that dystrophic calcification can be caused by an injection of a foreign body for aesthetic augmentation.

A Case of Scrotal Calcinosis Associated with Pilar Cyst / 대한피부과학회지

Idiopathic calcinosis of the scrotum appears in childhood as multiple, asymptomatic nodules of the scrotal skin that gradually increase in size and number and sometimes discharge a chalky material. Histopathologic examination shows calcific deposits of various sizes that are present in the dermis and often surrounded by foreign body granulomatous inflammation. The pathologic mechanism of this condition is not clear, but there is accumulating evidence for dystrophic calcification of cyst rather than an idiopathic genesis. Here we present a 34-year-old otherwise healthy man who had a 10-year history of multiple, asymptomatic, firm, subcutaneous nodules of the scrotal skin, which sometimes discharged a chalky material. The nodules were completely excised and 45 nodules were observed in the histopathologic examination. In addition to the typical findings of idiopathic calcinosis of the scrotum, seven intact cysts were observed among 45 nodules. Among the seven cysts there were five pilar cysts and two indeterminate cysts with diffusely calcified keratinous content and attenuated walls. A mixture of calcified keratinous material and inflammatory infiltrates was detected. These findings suggest that idiopathic calcinosis of the scrotum may be deriven from the dystrophic calcification of cysts.

A Case of Scrotal Calcinosis Associated with Epidermal Cysts / 대한피부과학회지

Scrotal calcinosis, consisting of solitary or multiple circumscribed calcium deposits within the dermis of the scrotum, is generally assumed to be one the idiopathic type of calcinosis. We present herein a case of serotal calcinosis associated with scrotal epidermal cysts in a 29-year-old male patient who had multiple, 2 to 6mm sized, yellowish or flesh colored nodules in the dermis, Histopathologically multiple ncdules showed intact epidermal cyzts, an epidermal cyst with a partialIy degenerated wall and surrounding foreign body reaction, and calcium deposits with foreign body reaction in the dermis without an epithelial lining around calcium deposit. Therefore, idiopathic scrotal calcinosis may repreeent the end stage of dystrophic calcificati.on associated with inflammation of the scrotal epidermal cysts.

Dystrophic Calcification Following Anterior Tibial Compartment Syndrome / 대한정형외과학회잡지

Usually the histologic response of muscle to the ischemia range from mild, reversible change to extensive necrosis and fibrosis in the case of anterior tibial compartment syndrome. But dystmphic calcification in the late stages is very rare condition.Only three cases were previously reported by Gallie and Broder et al in the literature. We are reporting six cases of dystrophic calcification following anterior tibial compartment syndrome in late stages. Onsets of dystrophic calcifications after original injuries ranged from twelve years to thirty-two years. Two out of six cases revealed painless maas in the anterior tibial compartment and remaining four cases revealed painful aases. At surgery, tooth-paste like, calcified material was evacuated in one of five operated cases and yellowish grey, brittle materials were evacuated in the remaining four cases.