Iatrogenic calcinosis cutis is due to the intravenous administration of calcium gluconate or calcium chloride to treat hypocalcemia. The arthors report three cases of calcinosis cutis with calcifications involving the upper or lower extremities in neonates following the extravasation of calcium gluconate. Three neonates, a 2-week-old girl, 4-week-old boy, and a 4-week-old girl, were consulted for indurated nodules after the intravenous administration of calcium gluconate at the intensive care unit. Complete remission of palpable nodule and calcification was observed on the radiograph at three weeks, four weeks and six months after the initial presentation in each. All three neonates with iatrogenic calcinosis curtis were resolved spontaneously without functional and cosmetic complications. According to enhancement of the patient's cognition about benign disease, a suitable explanation of the disease and avoiding unnecessary treatment through an early diagnosis of iatrogenic calcinosis cutis will reduce a number of potential medical malpractice disputes.
Administration, Intravenous ; Calcinosis ; Calcium Chloride ; Calcium Gluconate ; Calcium ; Cognition ; Dissent and Disputes ; Early Diagnosis ; Female ; Humans ; Hypocalcemia ; Infant, Newborn ; Intensive Care Units ; Lower Extremity ; Male ; Malpractice

PURPOSE: Focal organizing pneumonia (FOP) is a benign condition which is often difficult to differentiate from bronchogenic carcinoma, and many patients with FOP undergo invasive procedures. We tried to determine which CT features might help provide a confident diagnosis of FOP. MATERIALS AND METHODS: We retrospectively reviewed the medical records, chest radiographs and CT scans of 13 patients with histopathologically proven FOP. Initial chest radiographs in all 13 suggested bronchogenic carcinoma. The CT scans were reviewed by three radiologists, and final decisions were reached by consensus. They were analyzed in terms of the size, shape, contour and localization of the lesion, internal characteristics of the nodule, changes in surrounding structures, and changes in any of these findings, as revealed by follow-up chest CT scanning. RESULTS: FOP lesions were oval or triangular in shape and between 1.8 and 6.5 cm in their largest diameter. All had irregular margins and all but one were peripherally located. Eight (61.5%) were in contact with the pleura and five (38.5%) were located along the peripheral bronchovascular bundle, with pleural indentation; in eight (61.5%), post-contrast CT scanning revealed inhomogeneous enhancement, and four (30.8%) had pleural tags. In five (38.5%), there was coarse spiculation; for six (46.2%), air bronchograms were available, and in four (30.8%), satellite nodules were present. Spotty calcification and lymph node enlargement were each evident in one case only. Follow-up CT scanning, available in four cases, showed that the mass decreased in size in three and disappeared completely in one. CONCLUSION: Although there were no consistent CT features for differentiating focal organizing pneumonia from lung cancer, the possibility of the former should be considered when a peripherally-located oval or triangular-shaped mass is in broad contact with the pleura or is located along the bronchovascular bundle, and satellite nodules are also present.
Carcinoma, Bronchogenic ; Consensus ; Diagnosis ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Lymph Nodes ; Medical Records ; Pleura ; Pneumonia* ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed