A Rare Case of Tumoral Calcium Pyrophosphate Dihydrate Crystal Deposition Disease of the Wrist Joint

[Chondrocalcinosis: idiopathic or manifestation of rare metabolic diseases?]

Calcification in hyaline and fibrocartilage is caused by the deposition of calcium pyrophosphate dehydrate, commonly referred to as chondrocalcinosis. Clinically, this can lead to arthritis symptoms similar to a gout attack -"pseudogout". Nonetheless, also chronic or asymptomatic disease courses are possible. The prevalence of chondrocalcinosis increases with age. The diagnostic workup of degenerative joint disease, therefore, often reveals calcifications of articular cartilage as harmless incidental findings. However, particularly in patients younger than 60 years of age, chondrocalcinosis can be the symptom of an underlying metabolic disease. This review article highlights these rare diseases and presents unusual manifestations of chondrocalcinosis.

An Unusual Case of Huge Tophaceous Pseudogout Mimicking as a Tumor-Like Lesion around the Ankle Joint: A Case Report and Literature Review

Pseudogout or calcium pyrophosphate dihydrate deposition disease (CPPD) primarily affects the joints and the periarticular tissues. Tophaceous or tumoral pseudogout is a rare form of this disease which is seen around the joints of extremities. It can be misdiagnosed as a neoplastic condition because of its clinicoradiological similarities, and thus, a proper histopathological examination is indispensable. We report one such case of extra-articular deposition of the CPPD crystals in a 65-year-old man who presented with an asymptomatic swelling around the left ankle. Radiographs showed a dense homogenous calcification, and FNAC revealed dense calcium deposits with numerous rhomboid-shaped crystals. It was managed by en bloc excision, and postoperative biopsy reports confirmed the diagnosis. Possibility of pseudogout should be kept as a differential diagnosis in patients presenting with calcified soft tissue swellings and should be subjected to a detailed histopathological examination for confirmation.