Abstract
IntroductionCalcific myonecrosis is a rare condition in which muscle in a limb compartment undergoes necrosis and becomes peripherally calcified with central liquefaction. The patient usually presents with a slowly progressive enlarged mass that sometimes can be misdiagnosed as soft tissue sarcoma. Most of the reported cases showed that the disease occurs often after trauma or compartment syndrome. However, the case of calcific myonecrosis following snake bite is rarely reported.Case presentationA 66-year-old Thai woman presented with a gradually progressive enlarged mass over a period of 10 years in her left leg. She had a history of untreated compartment syndrome after she was bitten by a snake (Malayan pit viper) in her left leg when she was 14-years old. At presentation, a plain X-ray showed a large soft tissue mass at the anterior compartment of her left leg. A sheet-like mass with an enlarged central cavity combined with peripheral calcification and cortical erosion of her tibia were observed. A biopsy was performed and the result was negative for neoplastic cells. During a 5-year follow-up, the mass progressively enlarged and then became infected and finally broke through the skin. She was treated by excision of the mass and administration of antibiotics. The wound completed healed at 1 month postsurgery. There was no wound complication or disease recurrence at 1 year postoperation.ConclusionsThe diagnosis of calcific myonecrosis was done by history taking and radiographic interpretation. In an asymptomatic patient the management should be observation and clinical follow-up. A biopsy should be avoided due to the high rate of postoperative infection. Treatment of choice in a symptomatic condition is mass excision.
Highlights
Calcific myonecrosis is a rare condition in which muscle in a limb compartment undergoes necrosis and becomes peripherally calcified with central liquefaction
The diagnosis of calcific myonecrosis was done by history taking and radiographic interpretation
Calcific myonecrosis is a rare condition characterized by an area of muscle necrosis in a limb compartment with peripheral calcification and central liquefaction
Summary
Calcific myonecrosis is a rare condition that usually occurs after trauma or compartment syndrome. 7. Tucker SC, Josty I: Compartment syndrome in the hand following an adder bite. 8. Snyder BJ, Oliva A, Buncke HJ: Calcific myonecrosis following compartment syndrome: report of two cases, review of the literature, and recommendations for treatment. 9. Wang JW, Chen WJ: Calcific myonecrosis of the leg: a case report and review of the literature. Okada A, Hatori M, Hosaka M, Watanuki M, Itoi E: Calcific myonecrosis and the role of imaging in the diagnosis: a case report.
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