title: Uremic tumoral calcinosis in the cervical spine: case report.
abstract: Tumoral calcinosis is an uncommon condition characterized by the calcification of periarticular soft tissue. In uremic patients the disease is secondary to metabolic disturbances in predisposed patients. The authors report the case of a 73-year-old woman who presented with a new painful cervical mass while undergoing continuous ambulatory peritoneal dialysis for long-standing end-stage renal disease (ESRD). A CT scan of the neck showed a lobulated, calcified mass in the left paraspinal soft tissue at C2-3. This mass affected the facet joint and also extended into the neural foramen but did not cause any neurological compromise. Due to the patient's significant medical comorbidities, resection was deferred and the patient was followed in the clinic. Subsequent repeat imaging has shown a significant decrease in the size of the mass. In the context of ESRD, a diagnosis of uremic tumoral calcinosis (UTC) was made. The authors conducted a search of the PubMed and EMBASE databases and identified 7 previously reported cases of UTC of the cervical spine. They present a summary of these cases and discuss the etiology, diagnosis, and management of the condition. Although the metabolic disturbances seen in patients undergoing dialysis can lead to tumoral calcinosis, most reported cases involve large joints such as the shoulder or the hip; however, the spine can also be affected and should be considered in the differential diagnosis of patients with uremia as it can mimic aggressive bone-forming neoplasms.
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada; and.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Fatehi
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Toronto;|Institute of Medical Science, University of Toronto;
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Ahuja
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Toronto;|Department of Biostatistics and Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Shelly
authors.initials: S
authors.lastname: Wang
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Toronto;|Department of Surgery and Institute of Biomaterials and Biomedical Engineering, University of Toronto;|Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Ontario;
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Ginsberg
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D051437:Renal Insufficiency / Q000150:complications / Q000628:therapy; D013122:Spinal Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D014511:Uremia / Q000150:complications / Q000000981:diagnostic imaging*
keywords: ESRD = end-stage renal disease; UTC = uremic tumoral calcinosis; cervical spine; dialysis-related calcinosis; osteoblastic lesion; tumoral calcinosis; uremia