Cervical spine instability from tumoral calcinosis

Abstract

Dear Editor, In the present case, we describe the clinical presentation, surgical management, and long-term follow-up of a rare case of tumoral calcinosis-induced cervical spine instability. Tumoral calcinosis is a rare disease characterized by the deposition of calcium crystals in peri-articular soft tissue. It can be familial or associated with other conditions, typically metabolic or other illnesses that result in metabolic disturbances [5]. It most commonly affects large joints, such as the hip and shoulders, but has been described in smaller joints including the spine.When tumoral calcinosis occurs, it appears as multiloculated, solid calcifications that generally cause local swelling, pain, and restricted mobility of the adjacent joint. Surgical resection of these calcifications is associated with a variable rate of recurrence. In patients with associated metabolic abnormalities, recurrence rates up to 33 % have been reported [2]. Some reports also suggest that incomplete resection is associated with higher rates of recurrence [3, 4, 6]. While tumoral calcinosis occurs around joints, erosion into adjacent bone or joint is a rare complication. Tumoral calcinosis of the cervical spine with bone erosion and instability has only been reported once in the literature [1]. A uremic patient on chronic dialysis presented with C1-2 instability from tumoral calcinosis. We present a rare case of significant cervical spine instability caused by tumoral calcinosis-induced bone erosion in a patient without any metabolic disturbances or personal/family history of calcific disease. To the best of our knowledge, this represents the first case of cervical spine instability caused by tumoral calcinosis without any of the typical associated conditions.