Advertisement

Hyperphosphatemic Tumoral Calcinosis: a Rare Clinico-pathological Disorder

  • Amiteshwar SinghEmail author
  • Sameer Rege
  • Anurag Lila
  • Shrinivas Surpam
  • Roshan Chiranjeev
  • Samarth Patel
  • Siddhanth Vairagar
Images in Surgery
  • 3 Downloads

Abstract

Tumoral calcinosis (TC) is a rare clinic-pathological entity characterised by neoplasm-like (tumoral) calcium phosphate deposition (calcinosis) in the periarticular soft tissues. We report a case of a 24-year-old male who presented with a spontaneous onset, gradually increasing swelling in his left buttock since 3 years. On examination, a huge soft tissue mass involving the entire left gluteal region and thigh was present. After thorough workup including tissue biopsy, radiological imaging, and biochemical investigations, his swelling was diagnosed as tumoral calcinosis. TC is often misdiagnosed as soft tissue sarcoma but presence of several calcified masses with chronic inflammatory reaction clinches the diagnosis. He underwent complete surgical excision and was put on low phosphorus diet and phosphate binder (Sevelamer Carbonate 400–800 mg TDS orally with phosphate-binding antacids) referred to as phosphorous deprivation therapy. He showed a remarkable post-operative recovery with gain in weight and no recurrence after 1 year of follow-up.

Keywords

Tumoral calcinosis Hyperphosphatemic Periartiuclar mass Calcium Phosphorous 

Notes

Acknowledgments

We would like to thank the Dean of Our Institute for allowing us to use hospital records for research.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The procedure performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the individual participant included in the study.

References

  1. 1.
    Fathi I, Sakr M (2014) Review of tumoral calcinosis: a rare clinico-pathological entity. World J Clin Cases 2(9):409–414.  https://doi.org/10.1111/j.1365-4362.1996.tb02999.x CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Smack DP, Norton SA, Fitzpatrick JE (1996) Proposal for a pathogenesis-based classification of tumoral calcinosis. Int J Dermatol 35(4):265–271.  https://doi.org/10.1111/j.1365-4362.1996.tb02999.x CrossRefPubMedGoogle Scholar
  3. 3.
    Wilber JF, Slatopolsky E (1968) Hyperphosphatemia and tumoral calcinosis. Ann Intern Med 68(5):1044–1049.  https://doi.org/10.7326/0003-4819-68-5-1044 CrossRefGoogle Scholar
  4. 4.
    Prince MJ, Schaefer PC, Goldsmith RS, Chausmer AB (1982) Hyperphosphatemic tumoral calcinosis: association with elevation of serum 1, 25-dihydroxycholecalciferol concentrations. Ann Intern Med 96(5):586–591.  https://doi.org/10.7326/0003-4819-96-5-586 CrossRefPubMedGoogle Scholar
  5. 5.
    Mozaffarian G, Lafferty FW, Pearson OH (1972) Treatment of tumoral calcinosis with phosphorus deprivation. Ann Intern Med 77(5):741–745.  https://doi.org/10.7326/0003-4819-77-5-741 CrossRefPubMedGoogle Scholar

Copyright information

© Association of Surgeons of India 2019

Authors and Affiliations

  1. 1.Department of General SurgerySeth GS Medical College and King Edward Memorial HospitalMumbaiIndia
  2. 2.Department of EndocrinologySeth GS Medical College, and King Edward Memorial HospitalMumbaiIndia

Personalised recommendations