Calcific myonecrosis

Calcific myonecrosis is a rare complication of limb trauma, that may occur after many years. It is characterized by dystrophic calcification that develops in the late period following compartment syndrome usually in the lower limb. We present a 66-year-old man who developed calcific myonecrosis 35 years after surgical intervention for compartment syndrome secondary to a gunshot injury to the left thigh. He presented with pain and swelling in the left leg. On physical examination, there was a well-defined and immobile mass lesion in the anterolateral part of the left crus, soft in consistency and 20 x 8 x 6 cm in size, showing no relation with the joint. Radiographic evaluation showed linear calcifications in the left crus without osseous pathology. At surgery, all the fibers in the anterior tibial compartment were calcified and there was no attachment to the bone. The patient underwent an excisional biopsy. Histopathological evaluation of the specimens revealed calcific myonecrosis. At the end of one-year follow-up, the patient was symptomless, without any recurrence.