Multiple Tumoral Calcinosis in a Hemodialysis Patient
Tumoral calcinosis is a rare benign condition characterized by
deposition of calcium salt in different peri-articular soft tissue regions,
mainly in the juxta-articular areas.
It affects mostly African people, especially in the second decade,
but it can affect any age. The term tumoral calcinosis was first used
by Inclan et al in 1943, however, the condition itself was described
before in 1899 by Duret.
A 58-year-old patient, on chronic hemodialysis, presented with
a six-month history of three slightly painful swellings gradually
increasing in size located in the shoulder and both the hips.
Clinical examination found a mass on the right shoulder from
which there was a flow of thick yellowish-white liquid. It also
revealed the presence of three large lumps. The largest one on the
right hip extended to the lower third
of the thigh and was of firm consistency.
X-ray of the shoulder showed a periarticular calcified mass
of multi-locular appearance capping the humoral head without
lysing the bone.
Magnetic resonance imaging revealed the presence of several soft tissue masses
on both shoulders and both hips, giving a bees nest-like appearance.
Their matrix was osteoid and they were seen to infiltrate adjacent muscle whilst
sparing bones and joints. The radiological findings were very
suggestive of pseudotumoral calcinosis.
Laboratory tests showed a high serum calcium
concentration, a normal phosphate concentration and elevated
serum parathyroid hormone concentration.
After the diagnosis
of hypercalcemia with tumoral calcification secondary to chronic
renal failure was made, the patient was placed on a low calcium diet
and intensive hemodialysis sessions.
However, the calcifications
did not improve and the patient refused surgery.
Urol Androl Open J. 2020; 4(1): 1-3. doi: 10.17140/UAOJ-4-121