Metastatic Calcinosis of Gastric Mucosa

Abstract

Calcinosis cutis refers to the deposition of calcium salts in the cutaneous and subcutaneous tissue and is frequently associated with inflammation. Gastric calcinosis can be classified into metastatic, dystrophic, and idiopathic; metastatic calcinosis is the most common type. In metastatic calcification, calcium salts are deposited in normal soft tissues in the setting of altered metabolism of serum calcium and phosphorus and is a rare and serious complication of chronic renal failure. The important factors contributing to the development of metastatic calcinosis are hypercalcemia, hyperphosphatemia, and an elevated calcium-phosphate product. The most striking feature of this diagnosis is the calcification around the large joints. While it mostly involves dermis of small and medium-sized vessels, it can rarely affect the mucosal layers of the gastrointestinal (GI) tract. Calcinosis presents as a marker for the presence of calcifications in other organs, such as heart or lung, which can be life-threatening. Patients rarely present with clinical symptoms of GI upset, dyspepsia, or epigastric pain that are attributed to calcinosis. If patients present with GI symptoms, infectious causes remain to be higher on the differential. We present a case of incidental finding of gastric mucosal calcinosis during the workup and treatment of dysphagia.

Pulmonary alveolar microlithiasis combined with gastric mucosal calcification: a case report

“…Idiopathic calcification occurs in normal tissue without serum biochemical abnormalities. The kidneys and lungs are the preferred sites of calcification, mainly due to the relative intracellular alkalinity ( 6 ). Calcinosis rarely occurs in the stomach (GMC) ( 5 ).…”

Gastric calcinosis ulcer in a renal transplanted patient

“…Refractory cases to basic treatment could require endoscopic or surgical treatment. Given the potential fatality of the disease, the prevention of these complications in high-risk patients must be among the main therapeutic goals (1,3).…”

Pediatric Gastric Mucosal Calcinosis

“…Metastatic GMC refers to the deposition of calcium salts in normal tissues and is associated with serum electrolyte abnormalities, usually hypercalcemia or hyperphosphatemia secondary to diagnoses such as tumor lysis syndrome and end-stage renal disease ( 6 ). Calcifications are more commonly found in the stomach, lungs, and kidneys due to their relative intracellular alkalinity ( 1 , 3 , 7 ). Dystrophic GMC occurs when calcium salts collect in inflamed, fibrotic, or otherwise altered tissue in the setting of normal serum electrolytes ( 7 ).…”

“…Gastric mucosal calcinosis (GMC) refers to the deposition of calcium salts in gastric tissue. This finding has been described mainly in the adult population, with only a few reports in children (1–6). This report describes upper endoscopy findings of numerous gastric nodules in a 17‐year‐old female with abdominal pain and vomiting, who was ultimately diagnosed with GMC despite normal serum electrolytes.…”