Calcified Mass Research Articles

The Incidental Finding of the Senile Isolated Massive Tracheobronchial Calcification After Cardiac Surgery: An Unusual Case Report

Tracheobronchial calcification is a benign radiological finding seen in middle-aged and elderly females, usually of no clinical significance. We report a female with massive tracheobronchial calcification that is found incidentally after cardiac surgery.

Stone Babies: A Pictorial Essay With Insights From 25 Museal Lithopaedions.

Lithopaedion, or "stone baby," represents an exceptionally rare clinical phenomenon with fewer than 350 documented cases existing in the medical literature. This condition arises when an advanced extrauterine pregnancy ceases its developmental trajectory and undergoes a lithification process, potentially resulting in a calcified mass with fetal-like morphology. Typically, lithopaedions remain asymptomatic for decades, but may occasionally elicit acute symptoms necessitating medical intervention. However, predominantly, these entities are incidental findings discovered during radiological examinations or autopsies. In this article, we present a comprehensive overview of 25 lithopaedion cases, including unreported cases from several European medical museums. When feasible, additional radiological imaging was conducted to enhance diagnostic clarity. Furthermore, this article situates lithopaedions within a broader historical perspective and a detailed etiopathogenetic framework, elucidating the physiological and pathological mechanisms contributing to their formation. The phenomenon of lithopaedion is a testimony to the complex and often enigmatic nature of the human body. By compiling and scrutinizing a substantial number of cases, this review offers valuable insights into the clinical implications of lithopaedions. Furthermore, it highlights the necessity for ongoing research and meticulous documentation of rare medical conditions like this, in order to contribute to a deeper understanding of extraordinary phenomena.

Pseudocalcinosis Tumorale (Teutschlander Disease) in Chronic Hemodialysis Patients

Pseudotumoral calcinosis (CPT) is a condition characterized by the deposition of calcium phosphate crystals in the periarticular tissues, forming large calcified masses. Although the pathophysiology of CPT is not fully understood, an increase in the calcium-phosphate product beyond the precipitation threshold and severe hyperparathyroidism appear to play a significant role. Treatment remains controversial, with surgical excision often recommended. We report a case of CPT in a 74-year-old diabetic patient undergoing chronic hemodialysis who experienced progressively worsening pain in the left hip for six months, along with mobility difficulties. A CT scan revealed a calcified mass on the posterior thigh, likely explaining the electric shock-like pain, as well as compression of the superficial femoral artery causing decubitus pain resembling critical limb ischemia. The biological assessment showed elevated calcium-phosphate levels and hyperparathyroidism. Surgical excision is not indicated due to the mass’s proximity to vascular and nerve structures. This case highlights the diagnostic and therapeutic challenges of CPT, emphasizing the need for iterative angioplasties, considering that this condition is rare in chronic hemodialysis patients with calcified periarticular masses.

Ocular manifestations in a case of tumoral calcinosis

Tumoral calcinosis is a rare genetic disease characterized by calcium-containing crystal deposition as masses in the major joints of the body. We are presenting tumoral calcinosis with ocular manifestations. Clinical examination and imaging were performed. The patient presented with a bilateral hip mass. The radiology of the buttocks showed a calcified heterogeneous mass [Fig. 1]. Calcific depositions from the gluteal region and lid margin were excised and sent for cytology. The histopathological examination (HPE) report showed giant cells and calcifications [Fig. 2]. Blood reports revealed increased serum phosphate and parathyroid hormone (PTH) with normal calcium levels.

Calcified Maxillary Fibroma in a Patient on Hemodialysis for Seven Years.

The presentation of mineral bone disorder (MBD) in individuals with chronic kidney disease (CKD) may vary. Consequently, physicians should be capable of recognising this condition when there is a suspicion of its existence. This case report will describe a calcified maxilla tumour as a manifestation of CKD-MBD. Initially asymptomatic, a 32-year-old female presented with progressive swelling of the upper left jaw. She had a history of routine haemodialysis. Further laboratory, radiological, and histopathological workup revealed the mass was indeed calcified maxillary fibroma arising from the manifestation of CKD-MBD. This study underscores the significance of clinical comprehension of the broad-spectrum manifestations of CKD-MBD, including an initially asymptomatic mass. In addition, the screening of the patient's biochemical was required to determine the necessity of early intervention and improve the patient's outcome. The case emphasises the importance of recognising atypical presentations of chronic kidney disease-mineral bone disorder (CKD-MBD), such as a calcified mass, which are rarely reported but critical for timely intervention.This report underscores the necessity for routine screening for secondary hyperparathyroidism in CKD patients, as early detection can significantly impact patient outcomes.Surgical management of the overlying mass and underlying parathyroid gland hyperplasia should always be considered in the management of the symptomatic CKD-MBD patient.

Horseshoe kidney with teratoid type of Wilms tumor: a rare case report

BackgroundHorseshoe kidney is the most common renal fusion anomaly, and Wilms tumor is the most frequent renal malignancy in children. The occurrence of Wilms tumor in association with horseshoe kidney is a scarce anomaly. However, the arising of a teratoid type, which is a rare variant of Wilms tumor in a horseshoe kidney, is exceptionally unique.Case presentationThis report presents a 5-year-old male admitted with horseshoe kidney involved by a large heterogeneous calcified mass that was diagnose on biopsy as Wilms tumor blastemal dominant. According to the local and regional extension and metastatic tumor in the lungs, the patient underwent neoadjuvant chemotherapy and then surgery. Post-operative pathologic findings confirmed the diagnosis of teratoid Wilms tumor.ConclusionsThe occurrence of renal anomalies associated with a malignancy might be more frequent in the clinical environment. There are numerous differential diagnoses for renal tumors and masses, but the possibility of exceptional anomalies should not be denied, and clinicians should be prepared for these occasions. Although studies propose that chemotherapy has a trivial effect on teratoid Wilms tumors, it is essential to evaluate the tumor for any possibility of regression in non-teratoid regions before proceeding to upfront tumoral resection.

In vivo mapping of the mouse Galnt3-specific O-glycoproteome

The UDP-N-acetylgalactosamine polypeptide:N-acetylgalactosaminyltransferase (GalNAc-T) family of enzymes initiates O-linked glycosylation by catalyzing the addition of the first GalNAc sugar to serine or threonine on proteins destined to be membrane-bound or secreted. Defects in individual isoforms of the GalNAc-T family can lead to certain congenital disorders of glycosylation (CDG). The GALNT3-CDG, is caused by mutations in GALNT3, resulting in hyperphosphatemic familial tumoral calcinosis (HFTC) due to impaired glycosylation of the phosphate-regulating hormone FGF23 within osteocytes of the bone. Patients with hyperphosphatemia present altered bone density, abnormal tooth structure and calcified masses throughout the body. It is therefore important to identify all potential substrates of GalNAc-T3 throughout the body to understand the complex disease phenotypes. Here, we compared the Galnt3-/- mouse model, which partially phenocopies GALNT3-CDG, with wild-type mice and employed a multi-component approach utilizing chemoenzymatic conditions, a product-dependent method constructed using EThcD triggered scans in a mass spectrometry workflow, quantitative O-glycoproteomics, and global proteomics to identify 663 Galnt3-specific O-glycosites from 269 glycoproteins across multiple tissues. Consistent with the mouse and human phenotypes, functional networks of glycoproteins that contain GalNAc-T3-specific O-glycosites involved in skeletal morphology, mineral level maintenance and hemostasis were identified. This library of in vivo GalNAc-T3-specific substrate proteins and O-glycosites will serve as a valuable resource to understand the functional implications of O-glycosylation and to unravel the underlying causes of complex human GALNT3-CDG phenotypes.

Effects of high- versus low-intensity lipid-lowering treatment in patients undergoing serial coronary computed tomography angiography: results of the multi-center LOCATE study.

To evaluate the effects of lipid-lowering medications of different intensities on total, calcified, and non-calcified plaque volumes in patients undergoing serial cardiac computed tomography angiography (CCTA). Individuals with chronic coronary syndromes from 11 centers were included in a retrospective registry. Total, calcified, and non-calcified plaque volumes were quantified and the relative difference in plaque volumes between baseline and follow-up CCTA was calculated. The intensity of lipid-lowering treatment was designated as low, moderate, or high, based on current recommendations. Of 216 patients (mean age 63.1 ± 9.7years), undergoing serial CCTA (median timespan = 824.5 [IQR = 463.0-1323.0] days), 89 (41.2%) received no or low-intensity lipid-lowering medications, and 80 (37.0%) and 47 (21.8%) moderate- and high-intensity lipid-lowering agents, respectively. Progression of total and non-calcified plaque was attenuated in patients on moderate-/high- versus those on no/low-intensity treatment and arrested in patients treated with high-intensity statins or PCSK9 inhibitors (p < 0.001). Halted increase of non-calcified plaque was associated with LDL-cholesterol reduction (p < 0.001), whereas calcified plaque mass and Agatston score increased irrespective of the lipid-lowering treatment (p = NS). The intensity of lipid-lowering therapy robustly predicted attenuation of non-calcified plaque progression as a function of the time duration between the two CCTA scans, and this was independent of age and cardiovascular risk factors (HR = 3.83, 95% CI = 1.81-8.05, p < 0.001). The LOCATE multi-center observational study shows that progression of non-calcified plaques, which have been previously described as precursors of acute coronary syndromes, can be attenuated with moderate-intensity, and arrested with high-intensity lipid-lowering therapy. DRKS00031954.

Bizarre parosteal osteochondromatous proliferation in the distal ulna where the lesion is continuous with the medullary cavity: a case report

BackgroundBizarre parosteal osteochondromatous proliferation (BPOP) is a rare benign bone tumor, it is also called “Nora’s lesion”. The lesion is characterized by heterotopic ossification of the normal bone cortex or parosteal bone. The etiology of BPOP is unclear and may be related to trauma. In most BPOPs, the lesion is not connected to the medullary cavity. Here we report an atypical case, characterized by reversed features compared to the typical BPOP, which demonstrated continuity of the lesion with the cavity.Case presentationAn 11-year-old female child had a slow-growing mass on her right wrist for 8 months with forearm rotation dysfunction. Plain X-rays showed an irregular calcified mass on the right distal ulna, and computed tomography (CT) showed a pedunculated mass resembling a mushroom protruding into the soft tissue at the distal ulna. The medulla of this lesion is continuous with the medulla of the ulna. A surgical resection of the lesion, together with a portion of the ulnar bone cortex below the tumor was performed, and the final pathology confirmed BPOP. After the surgery, the child’s forearm rotation function improved significantly, and there was no sign of a recurrence at 1-year follow-up.ConclusionIt is scarce for BPOP lesions to communicate with the medullary cavity. However, under-recognition of these rare cases may result in misdiagnosis or inappropriate treatment thereby increasing the risk of recurrence. Therefore, special cases where BPOP lesions are continuous with the medulla are even more important to be studied to understand better and master these lesions. Although BPOP is a benign tumor with no evidence of malignant transformation, the recurrence rate of surgical resection is high. We considered the possibility of this particular disease prior to surgery and performed a surgical resection with adequate safety margins. Regular postoperative follow-up is of utmost importance, without a doubt.

Resection of the entire first rib for giant osteochondroma by trans manubrial approach: a case report and review of the literature

BackgroundFirst rib tumors are extremely rare. Its compression of neurovascularity can easily lead to severe complications such as thoracic outlet syndrome, so early surgical resection is crucial. However, there is no standardized approach to surgery.Case presentationA previously healthy 18-year-old Chinese male undergoes a chest computed tomography (CT) scan that incidentally reveals a raised calcified mass on the right first rib, which is most likely an osteochondroma when combined with magnetic resonance imaging (MRI). We achieved excellent results with resection and thoracic reconstruction by adopting an inverse L-shaped incision in the anterior chest and a longitudinal split of the sternum.ConclusionsOur practice provides great reference for the surgical management of first rib tumors.

Pulp stones in unerupted teeth: a retrospective analysis using cone-beam computed tomography

BackgroundA pulp stone is a calcified mass that develops in the dental pulp of any tooth. Despite many studies examining the relationship between pulp stone formation and non-oral factors, the methods used in these studies have been unable to explain the exact role of these factors alone as distinct from probable effects within the oral cavity environment. Considering that totally unerupted (impacted or developing) teeth are unexposed to the oral cavity’s environmental and functional conditions, they provide a more suitable material for studying the effects of these non-oral factors on pulp stone formation. This research study aimed to investigate pulp stones in unerupted teeth and the associated factors in a Saudi subpopulation.MethodsThe study included 644 cone-beam computed tomography images, with 496 (50.9%) maxillary and 479 (49.1%) mandibular teeth. Of the investigated patients, 293 (45.5%) were men, and 351 (54.5%) were women. The age range was 15–76 years. A chi-square test was used to investigate the associations between pulp stones and age, gender, and history of systemic disease and chronic medication use.ResultsPulp stones in unerupted teeth were present in 24.2% of the examined dental jaws and 18.6% of the examined teeth. There was no statistically significant relationship between pulp stones and gender (p > 0.05). A significantly greater percentage of pulp stones were found with increasing age (p = 0.000). Additionally, a significantly increased number of pulp stones was observed in patients with systemic diseases and chronic medications (p < 0.05).ConclusionsThe results support the idea that pulp stones can be present in any type of unerupted tooth. This study provides additional evidence of the increased incidence of pulp stones with age, systemic disease, and chronic medications.

Effect of low-dose radiotherapy in rotator cuff calcific tendinitis: A case report

Rotator cuff calcific tendinitis (RCCT) is an acute or chronic painful condition due to the presence of calcific deposits inside or around the tendons of the rotator cuff. Effective treatment of RCCT is crucial for restoring shoulder function, alleviating pain, and enhancing the patient’s quality of life. The treatment of RCCT is mainly divided into surgical and non-surgical treatment. Conservative treatment has been regarded as the first-line therapy, but the effectiveness of these treatments is still not well-established. When conservative treatment fails, invasive treatment, either minimally invasive or surgical, is usually indicated. Nowadays, low-dose radiotherapy has been used for the treatment of various benign conditions, including calcific tendinitis. We presented a 56-year-old female patient with intense pain and limited mobility of her left shoulder. X-rays and ultrasound of the left shoulder showed a massive oval calcification along the greater part of the m. supraspinatus measuring 41x8mm. The patient was first treated with diclopram, peranton gel, and rest. After that, it was decided to try low-dose radiotherapy. It was performed on the Vitalbeam radiotherapy platform with a conformal technique in doses of Gy 8 and 10 fractions. After the last fraction, the pain gradually disappeared and mobility was regained. The ultrasonography control 2 months after the last session showed the total disappearance of the calcification. The use of low-dose radiotherapy for benign conditions is a topic of ongoing debate in the medical community. In this case, low-dose radiotherapy proved to be an adequate method of choice without accompanying side effects, resulting in complete healing and improvement of quality of life.

Unilateral optic nerve aplasia associated with microphthalmia: a rare cadaveric report

This case report describes the anatomical presentation of the anomalous optic nerve (cranial nerve II). Cranial nerve II developmental anomalies encompass both optic nerve hypoplasia and aplasia. While most studies on optic nerve anomalies rely on radiological imaging, anatomical presentation and nerve course are rarely described. The current case reveals a complete absence of the right optic nerve and its connection to the optic chiasma, resembling radiological presentation of optic nerve aplasia. In addition, the right-sided bony orbit and eyeball were smaller than the left, accompanied by a poorly developed cornea and iris with a calcified mass, resembling clinical presentation of microphthalmia. Having a thorough understanding of the gross anatomical presentation and course of optic nerve anomalies can facilitate precise diagnosis and management of visual impairments associated with these anomalies. Furthermore, such knowledge can provide valuable insights into the actual prevalence of optic nerve aplasia and further substantiate the literature.

THE “SANDWICH” TECHNIQUE IN MITRAL ANNULAR CALCIFICATION

Abstract Objective To assess the feasibility and safety of the “Sandwich” technique in case of massive mitral annular calcification (MAC). MAC is a multifactorial chronic disease and a challenging clinical entity to the surgeon: both respecting and resecting techniques have been developed, in order to prevent eventual annular ruptures. Methods Twelve patients underwent mitral valve replacement (MVR) between January and September 2023, mainly because of steno–insufficiency of the mitral valve, in presence of MAC. Their mean age was 76 ± 4.5, their BMI was 27.2 ± 2.8 and their surgery was mostly elective, except for one urgent active endocarditis; their mean EUROscore II was 8.2 ± 2.9. Results We performed 12 MVR with biological valve, through full sternotomy approach. The cardiopulmonary bypass and aortic cross–clamp time were 195 ± 57 and 155 ± 42 minutes respectively. We perform a double line suture respectful of the annular calcium, in order to reinforce the mitral annulus, before fixing the prosthesis. Surgical stiches on the anterior annulus were ordinarily put; on the posterior annulus, which is usually the most calcified part, a teflon band underneath the calcium was fixed as first, through separate prolene 2–0 U–stitches. Then the usual 2–0 ticron stitches with pledget were put between the posterior annulus and the atrial wall. Both 2–0 prolene and ticron were passed through the prosthesis sewing ring: prolene was placed more externally than ticron. No leakages were found, both intraoperative and postoperative. There were no in–hospital deaths. No strokes, thromboembolic or coronary complications were observed. Conclusions The “Sandwich” technique is reproducible, feasible and safe and it does not imply a long surgical learning curve. It is not a disruptive approach, avoiding annulus failure and it is respectful of the cardiac structures.

A case of dedifferentiated liposarcoma discovered due to an intrascrotal calcified ossification.

Dedifferentiated liposarcoma is a rare cancer with a poor prognosis. A 52-year-old man presented with a chief complaint of a mass in his left scrotum. He came with suspected testicular tumor, but all the measured tumor markers were negative. Imaging test showed approximately 2cm diameter mass accompanied by calcification with some substantial components between the testis and epididymis. Left high testicular resection was performed. The tumor had no continuity between the testis and epididymis, and the spermatic cord transection was negative. Pathological findings showed well differentiated fatty component and a dedifferentiated component around the trabecular bone-like tissue. We observed dedifferentiated dysmorphic cells mixed with fatty droplets of unequal size. Immunostaining led to the diagnosis of dedifferentiated liposarcoma. No additional postoperative therapy was performed. The possibility of dedifferentiated liposarcoma should be kept in mind even if mass is confined to the scrotum and consisted of calcification. In the case of an intrascrotal calcified mass with malignant perspective, radical surgery is highly recommended.

Massive Myocardial Calcification: A Rare Autopsy Finding

Introduction: Myocardial calcification is rare and occur by two mechanisms- dystrophic and metastatic. It can present with variable clinical manifestations like congestive heart failure, cardiomyopathy, arrhythmia and sudden cardiac death. Case Report: Post mortem viscera of a 50 year old male was received in the department of pathology with alleged history of burns, who died after two weeks of hospital treatment. There was no past history or investigation available in the post mortem papers. Whole heart, pieces of brain, both lungs, liver, spleen and both kidneys were received. On gross examination no abnormality was observed in any of these viscera. Microscopic examination revealed extensive calcification in anterior, lateral &amp; posterior walls of left ventricle of the heart. Sections from kidney showed features of chronic tubulointerstitial nephritis. Conclusion: Myocardial calcification is rare and mostly diagnosed incidentally or on autopsy. Extensive sampling of heart and other viscera might help in finding the etiology in such rare cases of massive calcification in myocardium . Antemortem diagnosis can be made with computed tomography (CT) scan and endomyocardial biopsy.

The Curious Case of a 'Maverick' Cementoblastoma!

The Cementoblastoma is a benign ectomesenchymal odontogenic neoplasm of the jaw, arising from an exuberant production of cemental tissue continuous with the roots of teeth (usually mandibular posteriors), resulting in a calcified mass adherent with the root apices. A curious case of a large Cementoblastoma, the size and shape of a ping pong ball, is presented, the first of its kind ever reported to involve the internal / medial / lingual aspect of the mandible, and presenting with unusual and deviant features. The Cementoblastoma is usually associated with certain inherent and pathognomonic features, making it rather straightforward to identify and diagnose. Strikingly uncharacteristic clinical, radiographic and histologic attributes presented in this case, made this 'out of the ordinary' and 'Maverick'-like Cementoblastoma, arduous to diagnose, nevertheless, making it an interesting, informative and curious Case Study. This report has brought to light for the first time, several new facets of the Cementoblastoma.

Intracranial extra-axial chondromas: clues to computed tomography and magnetic resonance imaging diagnosis.

We aimed to describe the computed tomography (CT) and magnetic resonance (MR) imaging findings of intracranial extra-axial chondroma. We retrospectively evaluated the imaging findings of CT and MR examinations of six patients (three men and three women, aged 21-66 years) with histopathological diagnoses of intracranial extra-axial chondroma. Four tumors were located in the frontal region and two in the cavernous sinus. All the tumors showed low signals on diffusion-weighted images and high signals on apparent diffusion coefficient maps without restricted diffusion. There was no perifocal edema in all the tumors. Cavernous sinus chondromas were associated with bone erosion and anterior displacement of the internal carotid arteries, but without calcification. Calcification was present in all frontal chondromas. All the tumors revealed low signals on T1-weighted MR images. Frontal chondromas revealed mixed signals, but cavernous sinus chondromas were brightly hyperintense on T2-weighted MR images. No enhancement was detected in the two chondromas. An intense homogeneous enhancement was detected in a cavernous sinus chondroma. The imaging appearances of frontal extra-axial chondromas and cavernous sinus chondromas may have different imaging appearances. Although there is a wide range of imaging findings, the absence of restricted diffusion, perifocal edema, enhancement, and presence of low signals on T1-weighted MR images in a well-circumscribed calcified extra-axial mass should suggest an intracranial chondroma.

Antrolith: radiological diagnosis and surgical treatment – presentation of clinical cases

Introduction: Antrolith is a pathological calcified mass located in the paranasal sinuses, commonly in the maxillary sinus. When it is found in the vicinity or into the nasal cavity, it is also called rhinolith. In most of the cases, antroliths are incidentally identified through dental patients’ radiological examination. This fact underlines the need of antroliths’ detection in radiographs even by the general dentist. Objective: This paper aims to discuss the clinical and radiological diagnosis of antrolith, as well as its therapeutic methods, through the presentation of two clinical cases. Materials – Methods: Clinical cases, diagnosed with dental panoramic radiographs, radiographs of paranasal sinuses (Water’s view) and cone beam computed tomography (CBCT), are presented. Moreover, there has been conducted a review of the recent literature with scientific papers published in databases PubMed and Google Scholar. Results: Antrolith is usually an asymptomatic clinical feature, but painful symptomatology is rarely observed. Radiologically, it is mainly diagnosed with accuracy using orthopantomography and CBCT. As a pathological mass, antrolith should be differentiated from dental dysplasias, inflammatory calcifications, foreign bodies, even neoplasms in case of sizeable antroliths. The treatment choices of antroliths, depending on the severity of every clinical case, include frequent medical observation without any intervention or surgical excision techniques, most commonly the endoscopic sinus surgery or the removal through intraoral access. This article refers to two clinical cases of antroliths, one asymptomatic and one painful case, with all the diagnostic and management methodology being discussed. Conclusions: The radiological diagnosis of antroliths in conjunction with the endoscopic sinus surgery for its removal provide with the opportunity to treat and relieve patients with painful symptomatology. It is important not to be missed by the general dentist, as it may appear incidentally when evaluating panoramic radiographs. The assessment of antroliths is crucial for the differential diagnosis and its therapeutic management requires cooperation with a specialist.

PITUITARY STONE ADENOMA ASSOCIATED WITH SEVERE HYPERPROLACTINEMIA CASE REPORT

A 35-year-old patient consulting for erectile dysfunction, with a progressive visual acuity loss. Biological assessment revealed hyperprolactinemia at 4315 ng/ml and low testosteronemia at 6.8 nmol/l. Skull X-ray showed an enlarged sellaturcica with voluminous intra- and suprasellar calcifications. A cranial CT scan revealed an intra- and suprasellar calcified mass. Transphenoidal surgery was performed. The tumor was partially removed and the piece was made of calcified grayish granular tissue. Histological examination showed adenomatous cells with large granular calcification lesions. Immunohistochemistry confirmed prolactin adenoma. Cabergoline treatment was effective on the calcified tissue remaining after surgery.