A case of a generalized symptomatic calcinosis in systemic sclerosis.
Calcinosis consists of abnormal calcium deposition in soft tissues, which appears often in patients with limited systemic sclerosis, being one of the criteria of CREST (calcinosis cutis, Raynaud phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia) syndrome. With a long evolution, the aim of the treatment is to control the symptoms and prevent complications. In this article, we present the challenging management of a profuse lesion of calcinosis in a patient with systemic sclerosis. We describe the case of a 52-year-old woman with systemic sclerosis and CREST syndrome who was admitted in our Department with multiple painful and disabling tumoral masses, situated in nearly all joints. The interscapular vertebral tumoral mass was excised and the defect was closed. Histopathological examination revealed cutaneous calcinosis, probably associated with CREST syndrome, a type of scleroderma. Postoperative results were favorable and no local complications were encountered. Six months follow-up revealed no evidence of recurrence. Despite the size and the invasion of the tumor in the muscle, complete resection was possible with an adequate reconstruction; the postoperative result being acceptable. With a lower response to medication, surgical treatment is considered the only option for treating symptomatic lesions of calcinosis in order to improve quality of life.
Department of Plastic and Reconstructive Surgery, "Prof. Dr. Agrippa Ionescu" Emergency Clinical Hospital, Bucharest, Romania; cristina.cozma88@yahoo.com.
Cristian Radu
CR
Jecan
Ştefan Iulian
ŞI
Bedereag
Ruxandra Diana
RD
Sinescu
Valentin Titus
VT
Grigorean
Cristina Nicoleta
CN
Cozma
Anca
A
Bordianu
Ioan Petre
IP
Florescu
D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008875:Middle Aged; D010014:Osteolysis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012595:Scleroderma, Systemic / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery