Chronic recurrent multifocal osteomyelitis associated with tumoral calcinosis.

VOL. 76-B, No. 2, MARCH 1994 is often a family history of similar masses. Radiographicatty, the lesion appears as a welt-demarcated mass of lobutated, round or oval catcifications in the periarticular soft tissues. No bony abnormalities are seen and the joint space is not involved. Hyperphosphataemia is the only biochemical abnormality which has been detected (Reddy and Rao 1964; Lafferty, Reynolds and Pearson 1965; Baldursson et at 1969). Treatments have included excision, radiotherapy (Inclan 1943), special diets and various oral and parenteral drugs including corticosteroids and ACTH (Scott and DeLilly 1954). None has proved curative but there have been good results from early excision of initial and recurrent lesions. The clinical and histological features are not always so typical. The histological appearance of our case represents a variant of tumour calcinosis; the calcification is relatively mild and much of the tumour consists of macrophages and an osteoclast-tike or giant-cell reaction to the psammoma bodies which are composed of amorphous material. Confirmation of the diagnosis may be difficult because of the wide range of radiological and histological features. The radiographic appearance may arouse concern that there has been malignant change within a benign lesion, but careful histological analysis can usually reassure the patient and the surgeon that the lesion is innocent.