Pseudocalcinosis Tumorale (Teutschlander Disease) in Chronic Hemodialysis Patients
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Abstract
Pseudotumoral calcinosis (CPT) is a condition characterized by the deposition of calcium phosphate crystals in the periarticular tissues, forming large calcified masses. Although the pathophysiology of CPT is not fully understood, an increase in the calcium-phosphate product beyond the precipitation threshold and severe hyperparathyroidism appear to play a significant role. Treatment remains controversial, with surgical excision often recommended.
We report a case of CPT in a 74-year-old diabetic patient undergoing chronic hemodialysis who experienced progressively worsening pain in the left hip for six months, along with mobility difficulties. A CT scan revealed a calcified mass on the posterior thigh, likely explaining the electric shock-like pain, as well as compression of the superficial femoral artery causing decubitus pain resembling critical limb ischemia.
The biological assessment showed elevated calcium-phosphate levels and hyperparathyroidism. Surgical excision is not indicated due to the mass’s proximity to vascular and nerve structures. This case highlights the diagnostic and therapeutic challenges of CPT, emphasizing the need for iterative angioplasties, considering that this condition is rare in chronic hemodialysis patients with calcified periarticular masses.
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Lafferty FW, Reynolds ES, Pearson OH. Tumoral calcinosis: a metabolic disease of obscure etiology. Am J Med. 1965;38:105–118. Available from: https://doi.org/10.1016/0002-9343(65)90164-6
McClatchie S, Bremner AD. Tumoral calcinosis—an unrecognized disease. Br Med J. 1969;1(5637):153–155. Available from: https://doi.org/10.1136/bmj.1.5637.142-a
Rafaelsen S, Johansson S, Raeder H, Bjerknes R. Long-term clinical outcome and phenotypic variability in hyperphosphatemic familial tumoral calcinosis and hyperphosphatemic hyperostosis syndrome caused by a novel GALNT3 mutation; case report and review of the literature. BMC Genet. 2014;15:98. Available from: https://doi.org/10.1186/s12863-014-0098-3
Jellouli M, Gargah T. Tumoral calcinosis in a patient on hemodialysis. Pan Afr Med J. 2016;23:155. Available from: https://doi.org/10.11604/pamj.2016.23.155.8335
Harouna AD, Atarraf K, Afifi AM. Primary pseudotumoral calcinosis in children. Pan African Medical Journal. 2017;28. Available from: http://dx.doi.org/10.11604/pamj.2017.28.239.11313
Toubeau A, Malasi S, Sarbu N. Pseudotumoral calcinosis following bone fracture. J Belg Soc Radiol. 2019;103:53. Available from: https://doi.org/10.5334/jbsr.1869
MacDonald HM. Hyperphosphatemia and ectopic calcification: insights into tumoral calcinosis. Front Endocrinol. 2023;14:1075240.
DePuy T. Repeated joint trauma and its inflammatory consequences: implications for calcification. J Shoulder Elbow Surg. 2023;32(1):49-55.
Urena Torres P. Hyperparathyroidism of renal failure. SFE Toulouse. 2012;73:238-242.
Toubeau A, Malasi S, Sarbu N. Pseudotumoral calcinosis following bone fracture. J Belg Soc Radiol. 2019;103:53. Available from: https://doi.org/10.5334/jbsr.1869
Gennari L. Renal phosphate resorption mechanisms in chronic kidney disease. Kidney Int Rep. 2022;7(4):813-825.
Lafferty F, Reynolds E, Pearson O. Tumoral calcinosis, a metabolic disease of obscure etiology. Am J Med. 1965;38:105-18. Available from: https://doi.org/10.1016/0002-9343(65)90164-6
McKee PH, Liomba NG. Tumoral calcinosis, a pathological study of fifty-six cases. Br J Dermatol. 1982;107:669-674. Available from: https://doi.org/10.1111/j.1365-2133.1982.tb00526.x
Dussol B. Hyperparathyroidism and tumoral calcinosis in chronic renal failure: an update on the role of phosphate and calcium metabolism. Nephrol Ther. 2012;8(5):356-362.
K/DOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease: 2009 Update. Am J Kidney Dis. 2009;55(2):1-18.
Benchekroun TS, Benjelloun BS, Jorio-Bekhraba M, El Malki-Tazi A. Tumor calcinosis – about a case with review of the literature. Med Maghreb. 1999;76:5-8. Available from: https://www.santetropicale.com/Resume/7604.pdf
Sqalli Houssaini A, El Azizi El Alaoui J, Lefhal S, El Kabbaj D, Mountassir D, Chaouir S, et al. Periarticular calcification. Radiol leaflet. 2011;51:328-331. Available from: https://www.em-consulte.com/article/678259/calcification-periarticulaire
Fikri M, Allali N, Dafiri R. Tumor calcinosis in two pediatric cases. J Radiol. 2007;88:595-598. Available from: http://dx.doi.org/10.1016/S0221-0363(07)89862-3
Younes M, Belghali S, Zrour-Hassen S, Béjia I, Touzi M, Bergaoui M. Complete regression of tumoral calcinosis after subtotal parathyroidectomy in a hemodialysis patient. Rev Rum. 2008;75:882-885.
Harkess J, Peters H. Tumoral calcinosis: a report of six cases. J Bone Joint Surg. 1967;49:721-731. Available from: https://pubmed.ncbi.nlm.nih.gov/6026005/
Harouna AD, Atarraf K, Afifi AM. Calcinose pseudo-tumorale primitive chez l’enfant. Pan African Med J. 2017;28:239. Available from: https://doi.org/10.11604/pamj.2017.28.239.11313
En-Nafaa I, Africha T, Boussouga M, Semlali S, Chaouir S, Amil T, et al. Tumor calcinosis: report of a case. Arch Pediatrician. 2010;17(8):1165-1168. Available from: https://doi.org/10.1016/j.arcped.2010.05.005
Şenol U, Karaali K, Çevikola C, Dinçer A. MR imaging findings of recurrent tumoral calcinosis. Clin Imaging. 2000;24(3):154156. Available from: https://doi.org/10.1016/S0899-7071(00)00190-X
Aoun A, Baubion E, Banydeen R, Djiconkpode I, Ekindi N, Ureña-Torres P, Riaux A, et al. Incidence and characteristics of calciphylaxis in Martinique (2006-2012). Ann Dermatol Venereol. 2014;141:743-749. Available from: https://doi.org/10.1016/j.annder.2014.06.008
Goke FM, Bickel M. Calciphylaxis: a serious complication of end-stage renal disease. Clin Nephrol. 2013;79(6):478-486.
Khan AA. Calciphylaxis: a review of the pathophysiology and management. J Nephrol. 2016;29(2):229-240.
Malberti F, Ravani P. The choice of the dialysate calcium concentration in the management of patients on haemodialysis and haemodiafiltration. Nephrol Dial Transplant. 2003;7(Suppl.):37-40. Available from: https://doi.org/10.1093/ndt/gfg1077
Hamada J, Tamai K, Ono W, Saotome K. Uremic tumoral calcinosis in hemodialysis patients: clinicopathological findings and identification of calcific deposits. J Rheumatol. 2006;33:119-126. Available from: https://pubmed.ncbi.nlm.nih.gov/16395759/
Franco M, Van Elslande L, Passeron C, Verdier JF, Barrillon D, Cassuto-Viguier E, et al. Tumoral calcinosis in hemodialysis patients: a review of three cases. Rev Rhum Engl Ed. 1997;64:59-62. Available from: https://pubmed.ncbi.nlm.nih.gov/9051862/
Benkert H. Tumoral calcinosis: analysis of the pathogenesis and results of surgical treatment. Int Orthop. 2011;35(3):489-496.
Cohen LM, Parikh CR. Parathyroidectomy in patients with renal failure: a review of the literature. Am J Kidney Dis. 2006;47(2):185-197.
Matsumoto T. Endovascular treatment for critical limb ischemia. Circ J. 2014;78(4):911-919.