Tumoral Calcinosis in the Cervical Spine in a Patient with CREST Syndrome: A Case Report

Abstract

T umoral calcinosis is characterized by tumor-like periarticular deposits of calcium, and it commonly presents as a growing calcific mass in the soft tissue surrounding major joints1-6. It may be associated with bone erosion and destruction and may have a mass effect on neurovascular structures7-9. Tumoral calcinosis can be a component of CREST syndrome, an acronym for calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. Spinal and paraspinal tumoral calcinosis has been reported to involve both the vertebral bodies and the posterior elements of the cervical, thoracic, and lumbar spine6,10-18. To our knowledge, tumoral calcinosis of the cervical spine as a component of CREST syndrome has been reported in only three patients7,8,10. The diagnosis of tumoral calcinosis in the spine is difficult because of its rarity and its ability to mimic a neoplasm or infectious cause6,14,16,19. Neurologic deficits by mass effect can occur and may manifest as radiculopathy and/or myelopathy7-10,18. Moreover, it has been shown that tumoral calcinosis of the spine has presented diagnostic dilemmas to clinicians, radiologists, and pathologists because of a lack of familiarity with the entity16. We report the clinical presentation, radiographic findings, histopathologic results, and the surgical management of tumoral calcinosis of the cervical spine in a patient with CREST syndrome. Our patient is unique in that there was radiographic evidence of rapid progression of bone erosion and crystal deposition involving the posterior elements and paraspinal tissues within a one-year period. In addition, an anomalous, single vertebral artery on the affected side supplied the basilar artery system. The patient was informed that data concerning the case would be submitted for …