Tumoral calcinosis (Teutschlander disease) in a dialysis patient

Abstract

Tumoral calcinosis is an uncommon and severe complication of hemodialysis therapy. It is generally associated with the presence of the high serum calcium-and-phosphorus product. We report here a case of a patient on hemodialysis who presented with progressively increasing, multiple, tumor-like, subcutaneous swellings. These are rare manifestations of extraosseous calcification in uremic patients that are termed as tumoral calcinosis. A 25 year-old male presented with multiple, nodular, painful, cutaneous swellings all over his body that had been progressively increasing over the last four years. He was a known case of chronic glumerulonephritis who was on regular hemodialysis. The patient was investigated and diagnosed as having tumoral calcinosis and was treated with a low calcium dialysate of pure reverse osmosis water.

Fever as a Presentation of Tumoral Calcinosis: A Case Report

“…It involves dietary restriction of phosphate, noncalcemic phosphate binders, dialysis treatment with low calcium dialysate, parathyroidectomy in patients with high parathyroid hormone levels (due to tertiary hyperparathyroidism), surgical resection of the mass, or renal transplantation. (1) In this case, dietary restriction of phosphate, a non-calcemic phosphate binder, and low calcium dialysate was used to manage the extensive TC. A few cases have provided immunohistochemical and microscopic findings from the resected soft tissue calcifications, indicating involvement of histiocytes and osteoclast-like giant cells of histiocyte origin.…”

Massive, painful tumoral calcinosis in a long‐term hemodialysis patient

“…But recurrences due to poor circumscription are common, particularly when UTC is actively progressing . Dietary phosphate restriction, noncalcemic phosphate binders, and parathyroidectomy in patients with high PTH levels have been used . Sodium thiosulfate has been used in the absence of hyperparathyroidism or in the presence of a refractory high calcium‐and‐phosphate product .…”

“…5,17 Dietary phosphate restriction, noncalcemic phosphate binders, and parathyroidectomy in patients with high PTH levels have been used. 18,19 Sodium thiosulfate has been used in the absence of hyperparathyroidism or in the presence of a refractory high calcium-and-phosphate product. 20 There are reports of UTC presenting with signs of systemic inflammation leading to fever and other constitutional symptoms.…”

Avid 18F-FDG Uptake in Idiopathic Tumoral Calcinosis Mimicking Lymph Node Metastasis

“…Tumoral calcinosis may occur in all tissues [ 1 ]. This condition is a rare complication of chronic renal failure, and the genesis of the disease is related to high levels of calcium and phosphorus products and/or advanced secondary hyperparathyroidism after long-term dialysis [ 2 , 3 ]. High PTH (parathyroid hormone) can cause very high levels of plasma calcium.…”