Different outcomes following parathyroidectomy in patients with uremic tumoral calcinosis: two case reports

BMC Nephrol. 2023 Mar 15;24(1):55. doi: 10.1186/s12882-023-03107-3.

Abstract

Background: Uremic tumoral calcinosis (UTC) is a rare complication in hemodialysis patients, whose mechanism remains incompletely understood. We report two cases with UTC who experienced completely different patterns of regression following parathyroidectomy, although there were no significant differences in serum calcium levels, parathyroid hormone, or phosphorus production between the two patients.

Case presentation: Case 1 had a substantial improvement in soft tissue calcification. However, in Case 2, one calcified mass was partially absorbed, while the others were aggravated with severe microvascular calcification and subcutaneous extravascular calcification. Whole-exome sequencing data revealed five mutation sites associated with atherosclerosis.

Conclusion: The different outcomes in UTC patients after PTX are rare. Further studies are required to elucidate the mechanism of paradoxical changes occurring in patients with UTC after parathyroidectomy.

Keywords: Case report; Chronic renal failure; Genetic testing; Hyperparathyroidism; Parathyroidectomy; Treatment; Uremic tumor calcinosis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Calcinosis* / diagnostic imaging
  • Calcinosis* / etiology
  • Calcinosis* / surgery
  • Humans
  • Hyperparathyroidism, Secondary* / etiology
  • Kidney Failure, Chronic* / complications
  • Parathyroid Hormone
  • Parathyroidectomy / adverse effects
  • Phosphorus
  • Renal Dialysis / adverse effects

Substances

  • Phosphorus
  • Parathyroid Hormone