PMC3909847_01
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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However, prevertebral soft tissue calcification was observed with a curvilinear configuration at the level of C2 and C3 (Fig. 1A-D). Additional prevertebral calcification was found at the C3-4 and C6-7 intervertebral disc levels, and they were thought to be associated with degenerative changes in the intervertebral discs (Fig. 1D). A neck CT scan obtained 7 years ago demonstrated calcification at the same site (Fig. 1E-G). Follow-up C-spine lateral radiography after 1 year showed no change in size or configuration of the calcification (Fig. 1H).