Korean J Radiol.  2014 Feb;15(1):140-144. 10.3348/kjr.2014.15.1.140.

Growing Heterotopic Calcification in the Prevertebral Space of a Cervical Spine as a Late Complication of Irradiation: Case Report

• Park J
• Lee S
• Joo KB

• KMID: 1711489
• DOI: http://doi.org/10.3348/kjr.2014.15.1.140

Abstract

Heterotopic calcification following head and neck irradiation has rarely been reported. It usually develops as a late complication of radiotherapy in patients with malignancies, including breast cancer, lymphoma, and genitourinary malignancies. The occurrence of heterotopic calcification in the prevertebral space of the cervical spine has not been described as a late complication of irradiation. Here, we report a case of prevertebral heterotopic calcification in a patient with history of chemotherapy and radiotherapy for tonsil cancer 21 years ago.

Keyword

Calcification; Radiotherapy; Complications; Computed tomography

MeSH Terms

Aged
Calcinosis/*etiology/pathology/radiography
*Cervical Vertebrae/radiography
Female
Humans
Ossification, Heterotopic/*etiology/radiography
Radiation Injuries/complications
Tomography, X-Ray Computed
Tonsillar Neoplasms/*radiotherapy

Figure

• 

  Fig. 1 Heterotopic calcification in prevertebral space after radiotherapy in 74-year-old woman. A. Computed tomography (CT) scout image during admission shows curvilinear calcification (arrow) anterior to C2-3 with increase in size and change in configuration, in comparison to previous image. Slightly decreased soft tissue swelling is also noted (arrowhead). B-D. Axial contrast-enhanced CT images during admission on soft tissue (B) and bone (C) windows with sagittal reformat on bone windows (D) reveal increase in size of prevertebral calcification (arrows) anterior to C2-3. Radiation changes (arrowheads) in soft tissue are still noted. However, edematous change decreased slightly. Additionally, C2 and C3 demonstrate newly appearing osteopenia and trabecular coarsening suggesting osteoradionecrosis. Degenerative calcifications along intervertebral discs are also noted at C3-4 and C6-7 intervertebral disc levels. E. Initial CT scout image 7 years ago shows small ovoid calcification (arrow) anterior to C2 and associated with prevertebral soft tissue swelling (arrowhead). F, G. Initial axial contrast-enhanced CT images on soft-tissue (F) and bone (G) windows reveal dense globular calcification (arrows) anterior to C2 and associated radiation changes (arrowheads) in retropharyngeal, prevertebral, parapharyngeal, and carotid spaces. H. Follow-up lateral radiograph after 1 year shows no change in calcification (arrow) and prevertebral soft tissue swelling (arrowhead).

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