title: Hyperphosphatemic tumoral calcinosis: a 10-year follow-up.
abstract: OBJECTIVE
  To report a case of primary hyperphosphatemic tumoral calcinosis (TC) and its long-term 10-year follow-up.
  
  
  METHODS
  The patient was an 18-year-old male, who had been diagnosed with TC at the age of 8 years. In spite of nine surgeries for tumoral resection and medical treatments (i.e., aluminum hydroxide, non-steroidal anti-inflammatory agents) the lesions continued to progress. Physical examination showed calcified masses on shoulders, hip, elbows and right foot. PTH, calcitonin, 25(OH) vitamin D, 1,25(OH)2 vitamin D, renal and liver function, electrolytes, alkaline phosphatase, calcium and magnesium were normal. Serum phosphorus was elevated. FGF-23 (C-terminal): 1960 RU/mL (<180) Radiological and histological studies were compatible with TC.
  
  
  CONCLUSIONS
  This long-term follow-up illustrates the morbidity and difficulty in treating these patients due to the progressive and recurrent nature of the calcified masses, for which there is no effective treatment as yet. The discovery of FGF-23 as the factor responsible for the hyperphosphatemic type of TC paves the way for forthcoming therapies.
authors.affiliation: Pediatric Endocrinology Unit, Hospital Universitario Professor Edgard Santos, Faculty of Medicine, Federal University of Bahia, Brazil. cresio.alves@uol.com.br
authors.forename: Crésio
authors.initials: C
authors.lastname: Alves
authors.forename: Renata
authors.initials: R
authors.lastname: Lima
mesh_terms: D000293:Adolescent; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology*; D004550:Elbow / Q000000981:diagnostic imaging; D000089703:Fibroblast Growth Factor-23; D005500:Follow-Up Studies; D006615:Hip / Q000000981:diagnostic imaging; D006801:Humans; D054559:Hyperphosphatemia / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D011859:Radiography; D012782:Shoulder / Q000000981:diagnostic imaging; D012983:Soft Tissue Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D013997:Time Factors