A 23-year-old patient with secondary tumoral calcinosis: Regression after subtotal parathyroidectomy: A case report
| Autor: | Katharina E, Niemann, Feride, Kröpil, Martin F, Hoffmann, Marlon O, Coulibaly, Thomas A, Schildhauer |
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| Rok vydání: | 2016 |
| Předmět: |
sP
subtotal parathyroidectomy ROM range of motion CRP C reactive protein Tumoral calcinosis Parathyroidectomy WBC white blood cells Case Report THR total hip replacement TC tumoral calcinosis CT computed tomography KL KLOTHO FGF23 fibroblast growth factor 23 GALNT3 GalNAc transferase 3 Chronic kidney disease Teutschlaender disease PTH parathyroid hormone |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Tumoral calcinosis needs to be diagnosed correctly. • Subtotal parathyroidectomy leads to rapid regression. • Potential mutilations may be avoid by early subtotal parathyroidectomy. Introduction Tumoral calcinosis (TC) is a rare disorder defined by hyperphosphatemia and ectopic calcifications in various locations. The most common form of TC is associated with disorders such as renal insufficiency, hyperparathyroidism, or hypervitaminosis D. The primary (hereditary) TC is caused by inactivating mutations in either the fibroblast growth factor 23 (FGF23), the GalNAc transferase 3 (GALNT3) or the KLOTHO (KL) gene. Presentation of case We report here a case of secondary TC in end-stage renal disease. The patient was on regular hemodialysis and presented with severe painful soft-tissue calcifications around her left hip and shoulder that had been increasing over the last two years. Initially, she was treated with dietary phosphate restriction and phosphate binders. Because of high phosphate blood levels, which were not yet managed with dialysis and medical therapy, a subtotal parathyroidectomy (sP) was performed. This approach demonstrated significant response. Three months after surgery a rapid regression of the tumors was observed. Disscusion Regardless of the etiology, the two types of TC do not differ in their radiologic or histopathologic presentations but need to be diagnosed correctly to initiate targeted and effective treatment. Considering the primary TC, primary treatment is early and complete surgical excision. In case of secondary TC surgical excision of the tumoral masses should be avoid because of extensive complications. These patients benefit from sP. Conclusion After initial conservative therapy chronic kidney disease patients with TC might benefit from sP to avoid prolonged suffering and potential mutilations. |
| Databáze: | OpenAIRE |
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