A tumoral calcinosis is considered a rare disorder with a poorly understood etiology. This uncommon soft tissue calcification is characterized clinically by the presence of an irregular, painless, periarticular soft tissue calcifying mass. People from African decent are mainly affected with the disease, which typically occurs in the periarticular regions. We report a case of a middle aged woman who complained a left inguinal subcutaneous mass. The characteristic clinical features, radiological and pathological findings are described. A diagnosis of a tumoral calcinosis can be difficult to make due to the unfailiarity of its clinical and radiological features. This presented report will help surgeons to easily diagnose this condition.
Calcinosis* ; Diagnosis ; Female ; Humans ; Middle Aged

Aged ; Calcinosis ; diagnosis ; Female ; Humans ; Mitral Valve ; pathology

Tumoral calcinosis is a type of idiopathic calcinosis cutis which usually occurs around the large joints due to deposition of calcium phosphate, but extremely rare in the fingers which has been reported less than 20 cases in the literature. When it occurs on the fingers, it shows almost normal skin appearance and no specific symptoms except localized tenderness and numbness, therefore it is difficult to differential diagnosis among other common tumors on the fingers. In most cases surgical excision is performed before final diagnosis, and it is easy to misdiagnosis. The patient had mass like lesion which is enlarging for last 2 years at the radial side of the second finger without any trauma history. We prediagnosed the tumoral calcinosis with the simple radiologic test and laboratory tests and performed surgical excision without recurrence. So we report a case of tumoral calcinosis of the radial side of the second finger with brief review of the literature.
Calcinosis* ; Calcium ; Diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; Fingers* ; Humans ; Hypesthesia ; Joints ; Recurrence ; Skin

Adult ; Breast Neoplasms ; diagnosis ; surgery ; Calcinosis ; diagnosis ; diagnostic imaging ; Female ; Humans ; Mammography ; methods ; Mastectomy, Segmental

OBJECTIVETo explore the ultrasound (US) findings of partially cystic thyroid nodules (PCTNs) and to analyze their relationship with differential diagnosis of benign and malignant lesions.

METHODS265 cases of PCTNs confirmed by needle biopsy or surgical pathology were included in this study. Their ultrasound characteristics were reviewed and their significance in differential diagnosis was analyzed.

RESULTSIn the 265 PTCNs, 53 cases were malignant and 212 cases were benign lesions. According to the comparison of ultrasound and pathology results, there were 51 true-positive cases, 208 true negative cases, four false-positive cases and two false negative cases;the sensitivity was 96.2% (51/53), specificity was 98.1% (208/212), positive predictive value (PPV) was 92.7% (51/55), negative predictive values (NPV) was 99.0% (208/210), and accuracy rate was 97.7% (259/265). In terms of the PTCNs, internal structure, shape and margin were significantly associated with malignant or benign nature (P < 0.001); the aspect ratio ≥ 1, spiculated or micro-lobulated margin were significantly associated with malignancy; while the smooth margin, spongiform structure were significantly associated with benign nature. In terms of the internal solid portion of the nodules, the configuration, free margin, echogenecity, and calcification were significantly associated with malignant or benign nature (P < 0.001). The eccentric configuration with an acute angle, non-smooth free margin, hypoechogenecity, marked hypoechogenecity and micro-calcification were significantly associated with malignancy; while concentric configuration, smooth free margin, hyper/isoechogenicity, free margin of the solid component, and macro-calcifications were significantly associated with benign nature (P < 0.01). The results of logistic regression analysis showed that the echogenicity, free margin, configuration and calcification of the solid component were important predictive factors of malignant lesions (P < 0.05), that the hypoechogenecity, marked hypoechogenecity, eccentric configuration with an acute angle, non-smooth free margin and micro-calcification of the internal solid portion of the nodules were predictors for malignant PTCNs (P < 0.01).

CONCLUSIONUnderstanding the characteristics of US findings of partially cystic thyroid nodules is of great importance to make an accurate diagnosis of malignant nodules.

Biopsy, Needle ; Calcinosis ; diagnosis ; diagnostic imaging ; Diagnosis, Differential ; Sensitivity and Specificity ; Thyroid Nodule ; diagnostic imaging ; Ultrasonics ; Ultrasonography

The diagnosis of soft tissue osteochondroma should be considered when a well-defined osseous mass is located in the soft tissues. The differential diagnosis includes myositis ossificans, tumoral calcinosis, synovial chondromatosis, and soft tissue osteosarcoma, true osteochondroma which arises from bone. One case of soft tissue osteochondroma in the knee, a lesion of uncertain pathogenesis is reported.
Calcinosis ; Chondromatosis, Synovial ; Diagnosis ; Diagnosis, Differential ; Knee ; Myositis Ossificans ; Osteochondroma* ; Osteosarcoma

A 32-year-old woman with a long-standing systemic lupus erythematosus had multiple subcutaneous nodules on her axillae, iliac crests and limbs. Three years ago, these nodules began to appear and slowly became larger. Some of them amassed to form a large, fungating, lobulated mass on her right iliac crest. Roentgenographic and histological examination showed that they were calcium deposits. She was initially treated with aluminum hydroxide administration for nine months, which resulted in moderate decrease in size and softening in consistency, but not complete resolution. Then, the mass on the right iliac crest was excised, with an excellent early result.
Administration, Oral ; Adult ; Aluminum Hydroxide/therapeutic use* ; Biopsy ; Calcinosis/therapy* ; Calcinosis/etiology ; Calcinosis/diagnosis ; Case Report ; Female ; Human ; Lupus Erythematosus, Systemic/complications* ; Skin Diseases/therapy* ; Skin Diseases/etiology ; Skin Diseases/diagnosis

A 32-year-old woman with a long-standing systemic lupus erythematosus had multiple subcutaneous nodules on her axillae, iliac crests and limbs. Three years ago, these nodules began to appear and slowly became larger. Some of them amassed to form a large, fungating, lobulated mass on her right iliac crest. Roentgenographic and histological examination showed that they were calcium deposits. She was initially treated with aluminum hydroxide administration for nine months, which resulted in moderate decrease in size and softening in consistency, but not complete resolution. Then, the mass on the right iliac crest was excised, with an excellent early result.
Administration, Oral ; Adult ; Aluminum Hydroxide/therapeutic use* ; Biopsy ; Calcinosis/therapy* ; Calcinosis/etiology ; Calcinosis/diagnosis ; Case Report ; Female ; Human ; Lupus Erythematosus, Systemic/complications* ; Skin Diseases/therapy* ; Skin Diseases/etiology ; Skin Diseases/diagnosis

OBJECTIVETo seek for the ultrasound findings of thyroid nodules related to malignancy and benign, and to assess the role of TI-RADS in the ultrosound evaluation of thyroid nodules.

METHODSWe reviewed and analyzed the ultrasound characteristics of 1838 thyroid nodules confirmed by biopsy or surgical pathology, classified the thyroid nodules by TI-RADS grading criteria, and analyzed the malignancy rate and accuracy rate of different TI-RADS grading.

RESULTSAmong the 1 838 thyroid nodules, 1 160 cases were carcinomas confirmed by surgery, while benign nodules in 212 cases. The sensitivity, specificity, PPV, NPV, and accuracy rates were 99.7% (1 156/1 160), 41.0%(278/678), 74.3% (1 156/1 556), 98.6% (278/282), and 78.2% (1 434/1 838), respectively. There were significant differences between the malignant and benign thyroid nodules in echo, margin, shape, calcification, and blood flow (P<0.001). Hypoechogenicity, marked hypoechogenicity, ill-defined margin, microcalcification, a taller-than-wide shape, and nodule internal rich flow (type III) were significantly associated with malignancy, while hyper/isoechogenicity, smooth margin, macro/no-calcifications, a wider-than-tall shape, and nodules internal poor flow (type I or type II) were significantly associated with benign nodules. There were significant differences between the malignant rates and accuracy rates obtained by different TI-RADS classifications (P<0.01).

CONCLUSIONUnderstanding the ultrasound characteristics of benign and malignant thyroid nodules and applying TI-RADS grading criteria to correctly classify the thyroid nodules are crucial for the clinical treatment and prognosis.

Calcinosis ; Diagnosis, Differential ; Humans ; Sensitivity and Specificity ; Thyroid Nodule ; diagnostic imaging ; Ultrasonics ; Ultrasonography

OBJECTIVETo screen out the sonogram features for the differential diagnosis of benign and malignant thyroid small nodules (≤ 1.0 cm) by Logistics regression analysis, to establish the binary Logistic regression model of sonogram features as independent variable and investigate the value of wall configuration of ultrasonogrophic nodules in the differential diagnosis of benign and malignant thyroid small nodules.

METHODSA total of 208 thyroid nodules ≤ 1.0 cm in diameter in 190 patients were evaluated. With postoperative pathological examination or fine needle aspiration biopsy, 106 nodules were confirmed as benign and 102 as malignant. Ultrasonic features of thyroid nodules were evaluated for the differential diagnosis of benign and malignant small thyroid nodules based on pathological diagnosis as a gold standard, a Logistic model was obtained, and the odds ratio of variables were compared. The margin of thyroid nodule was divided into regular or irregular margin, and the latter was divided further into four subtypes: strip, triangular, antler and papillary. The border was divided into clear, fuzzy or both. The periphery was divided into those with normal and abnormal echo;. The calcification included no calcification, microcalcification and non-microcalcification.

RESULTSFour statistically significant features were obtained finally by Logistics regression analysis, including margin, border, periphery and calcification. A formula was constructed by two-variables logistic regression analysis and probability of malignancy = 1/(1 + e - z), in which z = 5.026 × margin + 4.218 × border + 4.024 × periphery + 3.892 × calcification - 15.247. The odds ratio of margin was higher than the other independent variables.

CONCLUSIONSLogistics regression analysis indicates that the calcification, border, periphery, and especially margin of thyroid nodules are significant features for differentiating benign and malignant thyroid nodules. The margin score was more intuitionistic for the differentialtion of benign and malignant thyroid nodules.

Biopsy, Fine-Needle ; Calcinosis ; Diagnosis, Differential ; Humans ; Logistic Models ; Thyroid Nodule ; diagnostic imaging ; pathology ; Ultrasonography