Multiple ectopic calcifications in subcutaneous tissues with chronic renal failure: A case report

BACKGROUND: Multiple tumor-like ectopic calcifications is a rare syndrome characterized by subcutaneous mass deposits of calcium phosphate in periarticular tissues. Although several cases of the surgical treatment of tumoral calcinosis have been reported, the present case is unique in that multiple ectopic calcifications in subcutaneous tissues were found in a hemodialysis patient who had been operated on a total of five times within a period of 1.5 years. METHODS: A hemodialysis 60-year-old male presented with multiple tumor-like ectopic calcifications bilateral in the shoulders, right buttock and right thigh. He had been operated on a total of five times within a period of 1.5 years; the operations included a subtotal parathyroidectomy with parathyroid autotransplantation in the right forearm. RESULTS: Complete excisions of the ectopic calcifications were performed in the left shoulder, right buttock and right thigh, without signs of recurrence in the same sites at follow-up. Incomplete excision of the ectopic calcification in the right shoulder resulted in recurrence in the same site, and the patient was operated on two more times 1.5 years following the initial surgery. Subtotal parathyroidectomy with parathyroid autotransplantation decreased serum levels of PTH, but the levels of serum calcium and phosphorus remained unchanged post-surgery, which appeared not to inhibit the recurrence of ectopic calcification in patients with CRF. CONCLUSIONS: If conservative therapy failed, then early and complete surgical excision may be a good therapeutic option.