Calcific myonecrosis: Report of 4 cases and review

Abstract

Calcific myonecrosis presents as a rare, late complication stemming from trauma or a neurovascular injury, predominantly affecting the lower limb. It manifests as a progressively enlarging, painful, dystrophic calcified mass, often following compartment syndrome and vascular or neurological compromise, leading to necrosis and fibrosis. While its radiological appearance is typically distinctive, biopsy is commonly pursued due to concerns of malignancy (as calcific myonecrosis may resemble soft tissue sarcoma), often resulting in superimposed infections. We describe 4 cases, all of which were males. 49, 76, 42, and 66 years old accordingly, 3 patients had a history of trauma, and one had a history of vascular injury. All patients were diagnosed with calcific myonecrosis years after initial trauma or injury. The diagnosis was based on clinical and imaging assessments. In cases of leg swelling associated with a calcified mass, particularly in the presence of prior trauma, consideration of calcific myonecrosis is crucial. Timely recognition can help avoid potential complications.