title: Tumoral calcinosis involving the cervical spine.
abstract: BACKGROUND
  Tumoral calcinosis (TC) is a disease of unknown etiology characterized by the presence of calcified masses in the juxta-articular regions of the extremities. Involvement of the cervical spine is very rare. In this report, the characteristics of TC of the cervical spine, including the clinical presentation, radiographic features, and surgical management are discussed.
  
  
  METHODS
  A 90-year-old healthy female suffering from numbness of the upper extremities for 3 months presented with a 2-week history of progressive weakness of the lower extremities. A neurological examination revealed mild weakness and sensory impairment of the bilateral upper and lower extremities. Computed tomography (CT) scans demonstrated amorphous calcified masses posterior to the spinous process that extended into the interlaminar spaces of C3/4 and C4/5. The masses involved the posterior elements of C3-C4. Interestingly, CT scans performed 4 years earlier showed subtle calcification of a yellow ligament at C3/4 and C4/5. However, neither calcified masses nor bone erosion were observed. On magnetic resonance (MR) imaging, the mass showed hypointensity on T1- and T2-weighted images. The lesion was compressing the spinal cord and was resected surgically. The pathological findings were consistent with those of TC. The natural history of TC is not understood. However, this case suggests that calcified masses may progress within several years and that the bone around the mass may be involved. Postoperatively, residual masses may disappear spontaneously, while new bone is formed in the erosive lamina and facet.
  
  
  CONCLUSIONS
  The treatment of choice for TC, if the lesion causes progressive symptoms, is surgical resection.
authors.affiliation: Department of Neurosurgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Japan 950-1197.
authors.forename: Osamu
authors.initials: O
authors.lastname: Sasaki
authors.affiliation: Department of Neurosurgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Japan 950-1197.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Neurosurgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Japan 950-1197.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nashimoto
authors.affiliation: Department of Pathology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, Japan 950-1197.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shibuya
keywords: Cervical spine; myelopathy; tumoral calcinosis