Bilateral Massive Trochanteric Gluteal Juxta Articular Tumoral Calcinosis in an Adolescent Girl: A Rare Case Report

Abstract

Juxta articular heterotopic ossification is well known but poorly understood clinico-pathological entity. It is commonly encountered in pediatric patients with trauma around Elbow joints and adult population with pelvi-acetabualr fractures, after pelvi-acetabualr open reduction internal fixation procedures and hip arthroplasty. Primary, hereditary and secondary renal or parathyroid tumoral calcinosis is rare clinical condition which mimics any large extraarticular calcified mass and sarcomas. Tumoral calcinosis is generalized pathological process which is often misdiagnosed and being confused with commonly described post traumatic or post-surgical localized juxta articular heterotopic ossification or myositis ossificans. It has largely non traumatic origin and involve extensor surfaces of large joints. The lesions are often multiple, bilateral, massive, well defined and lobulated cystic calcified mass. In contrast, heterotopic ossification or myositis ossificans is localized disease and caused by soft tissue trauma in the vicinity of joint, which usually present with ill-defined ossified soft tissue lesions and joint stiffness. Differential diagnosis of tumoral calcinosis includes heterotopic ossification or myositis ossificans, calcific tendinosis, calcific myonecrosis, synovial osteochondromas, gouty tophi, osteosarcomas and synovial sarcomas. In this case report we present a rare primary bilateral trochanteric gluteal Tumoral calcinosis with successful complete removal without recurrence for 3 years of continuous follow up.