Tumoral ectopic calcinosis causing cervical spinal cord compression in a patient with systemic sclerosis

Abstract

A 54 year-old woman complained of neck pain, weakness and dysesthesia of the upper limbs. She had a medical history of systemic sclerosis diagnosed at 52 years-of-age. Neurological examination revealed bilateral biceps reflexes are normal; however, bilateral triceps, patellar and Achilles' tendon reflexes were hyperactive. Cervical spinal magnetic resonance imaging showed a tumoral lesion located in the posterior part of the spinal canal at the levels of C3–5 (Fig. 1a,b), and its internal portion was not clearly enhanced with gadolinium (Fig. 1c). This lesion entirely showed high density on computed tomography (Fig. 1d), and was considered to be generated from an ectopic calcinosis as a result of systemic sclerosis. Macroscopic findings during surgery identified that ectopic calcinosis existed in the epidural space with intact dura mater. Pathological evaluation after the total resection (Fig. 1e) revealed it was actually a soft calcified tissue. After the surgical resection, the patient's clinical symptoms were remarkably improved. It should be noted that a tumoral ectopic calcinosis occurring in the spinal canal can rarely cause myelopathy or myeloradiculopathy in a patient with systemic sclerosis.1 The authors declare no conflict of interest.