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Review Question - QID 690

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QID 690 (Type "690" in App Search)
A 30-year-old African-American female presents to your clinic with right hip swelling. These symptoms have been present for over 3 years, but this is the first time she is seeking treatment. Figures A-E show radiographs, an MRI, and histology. What is the most likely diagnosis?
  • A
  • B
  • C
  • D
  • E

Osteochondroma

2%

39/1824

Chondrosarcoma

4%

73/1824

Dedifferentiated chondrosarcoma

6%

114/1824

Tumoral calcinosis

71%

1298/1824

Bizarre Parosteal Osteochondromatous Proliferation (Nora's disease)

16%

295/1824

  • A
  • B
  • C
  • D
  • E

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The history and imaging studies are most consistent with tumoral calcinosis.

Tumoral calcinosis is a relatively rare disorder of uncertain etiology most commonly seen in people of African descent and females. Metabolic defects, collagen vascular disorders, and trauma have been associated with the development of these lesions. Lesions grow slowly and rarely cause pain. The histologic appearance is characterized by loculated calcific debris surrounded by a fibrous stroma. Surgical removal is the treatment of choice for symptomatic lesions and incomplete removal is associated with recurrence.

The review by Martinez discusses the new recognition and understanding of this disease as described above.

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