Monckeberg’s Calcification as a Clinical Mimicker of Temporal Arteritis: A Case Report

Abstract

Temporal arteritis usually presents in patients above 50 years and is characterised by granulomatous inflammation in all layers of the arterial wall. On the other hand, Monckeberg medial calcification is a disease condition limited to the tunica media of the affected vessels. In this report, authors present the case of a 68-year-old man who presented to the casualty with facial pain. He also had a runny nose, cough, and sleep disturbance. A Computed Tomography (CT) scan was performed and reported as normal. The patient underwent Ear, Nose and Throat (ENT) and Ophthalmology evaluations. Neurology opinion revealed tenderness and thickening of the right superficial temporal artery. Based on clinical suspicion, the patient was started on oral corticosteroids, suspecting temporal arteritis. A temporal artery biopsy was performed for histopathological examination, which surprisingly revealed no evidence of arteritis but only calcification of the tunica media. Unfortunately, the patient was lost to follow-up after the biopsy. This case highlights the importance of recognising Monckeberg medial calcification in clinically suspected cases of temporal arteritis, as there are only a few reported cases in the literature.

Keywords

• monckeberg medial calcification
• persistent headache
• temporal artery biopsy