Tzu Chi Medical Journal
Volume 21, Issue 3 , Pages 239-243, September 2009

Surgical Excision of Tumoral Calcinosis of the Distal End of the Clavicle in a Patient With Uremia

  • Jui-Kuo Hung

      Affiliations

    • Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Orthopedic Surgery, Changhua Christian Hospital, 135, Nanhsiao Street, Changhua, Taiwan
  • ,
  • Ing-Lin Chang

      Affiliations

    • Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan
  • ,
  • Hui-Mei Chang

      Affiliations

    • Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan

Received 16 September 2008; received in revised form 3 October 2008; accepted 29 October 2008.

Abstract 

Tumoral calcinosis is an uncommon disease characterized by tumor-like lesions composed of calcium salt. This condition is not a true neoplasm but an imbalance of calcium and phosphorus metabolism resulting from hereditary causes or secondary defects. Medical therapy to balance calcium and phosphorus is the cornerstone of treatment. However, when pain or other compression symptoms occur, surgical excision is indicated. We report a 53-year-old man who presented with a swollen mass over his left shoulder with severe pain and a decreased range of motion for about 6 months. He had a history of chronic renal failure and was on hemodialysis for 20 years. After serial examinations, hyperphosphatemia, hypocalcemia, and secondary hyperparathyroidism were diagnosed. Excision of the mass was performed. The pathological examination results revealed tumoral calcinosis. He was then referred to a nephrologist to adjust the medication, and dialysate was supplied to balance the calcium and phosphorus metabolism. He recovered well without significant complications or recurrence after 5 years of follow-up.

Keywords:  Distal end of the clavicle , Hemodialysis , Surgical excision , Tumoral calcinosis

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PII: S1016-3190(09)60046-X

doi:10.1016/S1016-3190(09)60046-X

Tzu Chi Medical Journal
Volume 21, Issue 3 , Pages 239-243, September 2009