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

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.

New method of local adjuvant therapy with bicarbonate Ringer’s solution for tumoral calcinosis: A case report

“…Parathyroidectomy is effective for tumoral calcinosis patients, especially patients with secondary hyperparathyroidism[ 5 ]. Following a parathyroidectomy, calcified tissue is significantly resorbed; however, bone renewal is reduced following parathyroidectomy because of lower parathyroid hormone (PTH) levels, resulting in increased circulating calcium and promotion of vessel and soft tissue calcification[ 19 , 20 ].…”