Subdeltoid bursa tumoral calcinosis

Case contributed by Dr Vinay V Belaval

Presentation

Swelling of left shoulder region.

Patient Data

Age: 20 years
Gender: Male

MRI of left shoulder shows a well defined, heterogeneous multilocular cystic mass lesion in the subdeltoid bursa (occupying entire bursal region) with multiple T2w and T1w hypointense fluid levels. No intraarticular extension. Mild oedema is noted around the lesion as evident on PD-fat sat image.

Axial bone window of left shoulder showed heterogeneous calcified mass lesion in subdeltoid bursa with multiple hyperdense fluid levels - representing layered "milk of calcium". 

Case Discussion

This young patient presented with left shoulder swelling. 

MRI images showed a heterogeneous mass within the subdeltoid bursa showing sedimentation sign, which was confirmed on CT. Biochemical parameters were within normal limits. The diagnosis of "tumoral calcinosis of subdeltoid bursa" was made.

Tumoral calcinosis is a hereditary disorder of phosphate metabolism characterised by large, painless periarticular calcified masses predominantly involving the major joints. Secondary causes of dystrophic or metabolic calcifications should be ruled out. 

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Case information

rID: 58598
Published: 27th Feb 2018
Last edited: 1st Mar 2018
Inclusion in quiz mode: Included
Institution: Belcity scan and diagnostic centre, Belgaum

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