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Supraspinatus Intramuscular Calcified Hematoma or Necrosis Associated with Tendon Tear.

Lädermann A, Genevay M, Abrassart S, Schwitzguébel AJ - Case Rep Orthop (2015)

Bottom Line: We describe a patient with voluminous calcified mass entrapped in supraspinatus muscle associated with corresponding tendon tear.Discussion and Conclusion.This association has never been described.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedics and Trauma Surgery, La Tour Hospital, rue J.-D. Maillard 3, 1217 Meyrin, Switzerland ; Faculty of Medicine, University of Geneva, rue Michel-Servet 1, 1211 Geneva, Switzerland ; Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland.

ABSTRACT
Introduction. Rotator cuff intramuscular calcification is a rare condition usually caused by heterotopic ossification and myositis ossificans. Case Presentation. We describe a patient with voluminous calcified mass entrapped in supraspinatus muscle associated with corresponding tendon tear. Histological examination corresponded to a calcified hematoma or necrosis. Patient was surgically managed with open excision of the calcified hematoma and rotator cuff arthroscopic repair. At 6 months, supraspinatus muscle was healed, and functional outcome was good. Discussion and Conclusion. We hypothesized that supraspinatus intramuscular calcified hematoma was responsible for mechanical stress on the tendon. This association has never been described.

No MeSH data available.


Related in: MedlinePlus

In situ, macroscopic, and histologic aspects of calcified mass. In situ (a) and postextraction (b) macroscopic aspects of calcified mass showed a 7 × 4 × 4 cm well-delimited whitish solid tumor. Histologic evaluation ((c) and (d)) showed a highly hyalinized collagenous scar tissue devoid of any inflammatory cells, with some dystrophic calcifications at the periphery of the lesion (d).
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fig2: In situ, macroscopic, and histologic aspects of calcified mass. In situ (a) and postextraction (b) macroscopic aspects of calcified mass showed a 7 × 4 × 4 cm well-delimited whitish solid tumor. Histologic evaluation ((c) and (d)) showed a highly hyalinized collagenous scar tissue devoid of any inflammatory cells, with some dystrophic calcifications at the periphery of the lesion (d).

Mentions: Surgery was performed in order to remove the calcified supraspinatus mass. A small type A [21] rotator cuff lesion was also repaired under arthroscopy. First, tension on supraspinatus tendon was reduced by extracting calcific mass (Figure 2(a)). Next, an open approach between the trapezius and supraspinatus muscles was performed. A cleavage plane between calcific mass and supraspinatus muscle was well-delineated. Therefore, excision margins were not necessary. Then, arthroscopic procedure was performed to repair supraspinatus and superior subscapularis tendons with side to side point. Lateral acromioplasty, as well as bursectomy, was also performed.


Supraspinatus Intramuscular Calcified Hematoma or Necrosis Associated with Tendon Tear.

Lädermann A, Genevay M, Abrassart S, Schwitzguébel AJ - Case Rep Orthop (2015)

In situ, macroscopic, and histologic aspects of calcified mass. In situ (a) and postextraction (b) macroscopic aspects of calcified mass showed a 7 × 4 × 4 cm well-delimited whitish solid tumor. Histologic evaluation ((c) and (d)) showed a highly hyalinized collagenous scar tissue devoid of any inflammatory cells, with some dystrophic calcifications at the periphery of the lesion (d).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4563087&req=5

fig2: In situ, macroscopic, and histologic aspects of calcified mass. In situ (a) and postextraction (b) macroscopic aspects of calcified mass showed a 7 × 4 × 4 cm well-delimited whitish solid tumor. Histologic evaluation ((c) and (d)) showed a highly hyalinized collagenous scar tissue devoid of any inflammatory cells, with some dystrophic calcifications at the periphery of the lesion (d).
Mentions: Surgery was performed in order to remove the calcified supraspinatus mass. A small type A [21] rotator cuff lesion was also repaired under arthroscopy. First, tension on supraspinatus tendon was reduced by extracting calcific mass (Figure 2(a)). Next, an open approach between the trapezius and supraspinatus muscles was performed. A cleavage plane between calcific mass and supraspinatus muscle was well-delineated. Therefore, excision margins were not necessary. Then, arthroscopic procedure was performed to repair supraspinatus and superior subscapularis tendons with side to side point. Lateral acromioplasty, as well as bursectomy, was also performed.

Bottom Line: We describe a patient with voluminous calcified mass entrapped in supraspinatus muscle associated with corresponding tendon tear.Discussion and Conclusion.This association has never been described.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedics and Trauma Surgery, La Tour Hospital, rue J.-D. Maillard 3, 1217 Meyrin, Switzerland ; Faculty of Medicine, University of Geneva, rue Michel-Servet 1, 1211 Geneva, Switzerland ; Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland.

ABSTRACT
Introduction. Rotator cuff intramuscular calcification is a rare condition usually caused by heterotopic ossification and myositis ossificans. Case Presentation. We describe a patient with voluminous calcified mass entrapped in supraspinatus muscle associated with corresponding tendon tear. Histological examination corresponded to a calcified hematoma or necrosis. Patient was surgically managed with open excision of the calcified hematoma and rotator cuff arthroscopic repair. At 6 months, supraspinatus muscle was healed, and functional outcome was good. Discussion and Conclusion. We hypothesized that supraspinatus intramuscular calcified hematoma was responsible for mechanical stress on the tendon. This association has never been described.

No MeSH data available.


Related in: MedlinePlus