New method of local adjuvant therapy with bicarbonate Ringer’s solution for tumoral calcinosis: A case report

Figure 1 Plain radiograph and computed tomography of tumoral calcinosis. A-C: The images have an opaque and nodular appearance in the right shoulder 12 months (A) and 3 months before the operation (B) and the bilateral hips (C); D-G: Computed tomography (CT) shows calcified multi-cystic lesions in the right shoulder (D and E) and the bilateral hips (F and G); E and G: Axial CT shows each cyst has fluid-fluid level with a dense CT value at the bottom.

Figure 2 Magnetic resonance imaging and perioperative images. A-D: The magnetic resonance (MR) images reveal multi-cystic lesions with low-to-high signal intensity on T2- (A and B) and T1-weighted images (C and D); A: Axial T2-weighted image shows a fluid-fluid level with a high signal at the top and a low signal at the bottom; B and D: Coronal MR images show brachial plexus and subclavian vessels between the lesion and the chest wall (orange arrows); E: Three-dimension computed tomography shows the extension of the calcified lesion; F: The operation field shows solid calcified lesion trapped in the fibrous wall; G: A photograph shows swelling and planned incision line; H: After the resection, the plain radiograph shows residual calcified fluid and the materials over the operative field.

Figure 3 Tumoral calcinosis in the foot. A-C: A plain radiograph (A) and computed tomography (B and C) shows a calcified lesion of the foot; D: A photograph shows swelling and the planned incision line; E: Calcified lesion deposits at the wall after the calcified lesion were removed with suction and curettage; F: The resected calcified material had no reaction in saline (left), but became turbid and dissolved in bicarbonate Ringer’s solution (right); G: The calcified lesion was almost removed and no additional deposition was noted 6 months postoperatively.