Regression of massive tumoral calcinosis of the ischium in a dialysis patient after treatment with reduced calcium dialysate and i.v. administration.
BACKGROUND
Tumoral calcinosis, an inherited metabolic disorder, has been described with increasing frequency over the last 20 years [Drueke 1966]. It is characterized by massive calcium phosphate deposits in periarticular tissues, usually around large joints, especially the hips, knees and elbows (editorial in Lancet 1987).


METHODS
We describe a 58-year-old male patient with tumoral calcinosis of the ischium and severe hyperparathyroid bone disease, successfully treated with reduced calcium dialysate and vitamin D.


CONCLUSIONS
We believe that in cases of tumoral calcification with histologically proven hyperparathyroid bone disease, lowering the calcium dialysate concentration together with careful administration of vitamin analogs and monitoring of serum calcium, phosphate and parathyroid hormone levels, may be the ideal therapeutic approach. Control of hyperphosphatemia would be best achieved with measures other than administration of aluminium phosphate binders if one wishes to avoid the induction of adynamic bone.
Apostolou
T
T
Department of Medicine, Evangelismos General Hospital, Athens, Greece.
Tziamalis
M
M
Christodoulidou
C
C
Fountas
P
P
Billis
A
A
D002114:Calcinosis / Q000188:drug therapy*; D002118:Calcium / Q000008:administration & dosage* / Q000032:analysis / Q000097:blood; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000188:drug therapy*; D015312:Hemodialysis Solutions / Q000008:administration & dosage* / Q000032:analysis; D006801:Humans; D006887:Hydroxycholecalciferols / Q000008:administration & dosage / Q000627:therapeutic use*; D007275:Injections, Intravenous; D007512:Ischium / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D012074:Remission Induction; D006435:Renal Dialysis
D015312:Hemodialysis Solutions; D006887:Hydroxycholecalciferols; D010281:Parathyroid Hormone; D010710:Phosphates; D002118:Calcium; C008088:alfacalcidol