Calcified Leiomyoma of the Distal Forearm in a Child: A Case Report and Review of Literature

BACKGROUND: Deep somatic leiomyomas arising in skeletal muscle are extremely rare in children, especially in the extremities. Around half of them show calcifications. We present a rare case of a calcified leiomyoma of the distal forearm in a child. Case Summary. A seven-year-old boy presented with right distal forearm and wrist pain with restricted supination for 4 years. X-ray showed ring and arc calcifications in the distal forearm at the interosseous area. MRI also confirmed a well-defined soft tissue lesion with areas of calcifications. A diagnosis of a cartilage-forming lesion or a peripheral nerve sheath tumour was suggested. The lesion was completely excised. Histology showed a lesion composed of intersecting fascicles of spindle cells with stromal calcification having immunohistochemical features of a leiomyoma. CONCLUSION: Although soft tissue calcifications can be seen in a plethora of conditions seen in daily orthopaedic practise, a high index of suspicion should be maintained for rare conditions like deep somatic leiomyoma.