Hip & pelvis

The Korean Hip Society (대한고관절학회)
권호 표지
DOI QR코드

DOI QR Code

Pathologic Fracture of Femoral Neck in a Patient with Tumoral Calcinosis

  • Seong-San Park (Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital) ;
  • Soo Jae Yim (Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital) ;
  • Sin Hyung Park (Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital)
  • Received : 2021.09.23
  • Accepted : 2021.10.29
  • Published : 2022.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Tumoral calcinosis is a rare disease characterized by massive subcutaneous soft tissue deposits of calcium phosphate around large joints in patients with chronic kidney disease. Invasion of bone by tumoral calcinosis is rare. We experienced a case involving a femoral neck pathologic fracture due to bony invasion of tumoral calcinosis in a 46-year-old female with chronic kidney disease who had been on dialysis for 15 years. Successful outcomes were obtained by performance of total hip arthroplasty for treatment of the pathologic fracture of the femoral neck. Careful precaution is necessary to prevent pathologic fractures in patients with tumoral calcinosis around the hip joint.

Keywords

References

  1. Olsen KM, Chew FS. Tumoral calcinosis: pearls, polemics, and alternative possibilities. Radiographics. 2006;26:871-85. https://doi.org/10.1148/rg.263055099
  2. Chaabane S, Chelli-Bouaziz M, Jelassi H, Mrad K, Smida M, Ladeb MF. Idiopathic tumoral calcinosis. Acta Orthop Belg. 2008;74:837-45.
  3. Knowles SA, Declerck G, Anthony PP. Tumoral calcinosis. Br J Surg. 1983;70:105-7. https://doi.org/10.1002/bjs.1800700217
  4. Martinez S, Vogler JB 3rd, Harrelson JM, Lyles KW. Imaging of tumoral calcinosis: new observations. Radiology. 1990;174:215-22. https://doi.org/10.1148/radiology.174.1.2294551
  5. Bishop AF, Destouet JM, Murphy WA, Gilula LA. Tumoral calcinosis: case report and review. Skeletal Radiol. 1982;8:269-74. https://doi.org/10.1007/BF02219621
  6. Kim Y, Hwang E, Park S. Resolution of uremic tumoral calcinosis in a patient on peritoneal dialysis with long-term lowcalcium dialysate treatment. Kidney Res Clin Pract. 2014;33:226-8. https://doi.org/10.1016/j.krcp.2014.09.002
  7. Girard CJ 2nd, Wasserman PL, Lenchik L. Secondary tumoral calcinosis with intraosseous penetration. Radiol Case Rep. 2016;4:213.
  8. Chu HY, Chu P, Lin YF, Chou HK, Lin SH. Uremic tumoral calcinosis in patients on peritoneal dialysis: clinical, radiologic, and laboratory features. Perit Dial Int. 2011;31:430-9. https://doi.org/10.3747/pdi.2009.00250
  9. Sunder S, Verma H, Venkataramanan K. Cervical tumoral calcinosis with secondary hyperparathyroidism in a chronic hemodialysis patient. Hemodial Int. 2013;17:458-62. https://doi.org/10.1111/j.1542-4758.2012.00760.x
  10. Steinbach LS, Johnston JO, Tepper EF, Honda GD, Martel W. Tumoral calcinosis: radiologic-pathologic correlation. Skeletal Radiol. 1995;24:573-8. https://doi.org/10.1007/BF00204854
  11. Kindblom LG, Gunterberg B. Tumoral calcinosis. An ultrastructural analysis and consideration of pathogenesis. APMIS. 1988;96:368-76. https://doi.org/10.1111/j.1699-0463.1988.tb05318.x
  12. Boyce AM, Lee AE, Roszko KL, Gafni RI. Hyperphosphatemic tumoral calcinosis: pathogenesis, clinical presentation, and challenges in management. Front Endocrinol (Lausanne). 2020;11:293.
  13. Carmichael KD, Bynum JA, Evans EB. Familial tumoral calcinosis: a forty-year follow-up on one family. J Bone Joint Surg Am. 2009;91:664-71. https://doi.org/10.2106/JBJS.G.01512
  14. Hamada J, Tamai K, Ono W, Saotome K. Uremic tumoral calcinosis in hemodialysis patients: clinicopathological findings and identification of calcific deposits. J Rheumatol. 2006;33:119-26.
  15. Younes M, Belghali S, Zrour-Hassen S, Bejia I, Touzi M, Bergaoui N. Complete reversal of tumoral calcinosis after subtotal parathyroidectomy in a hemodialysis patient. Joint Bone Spine. 2008;75:606-9. https://doi.org/10.1016/j.jbspin.2007.08.012
  16. Meltzer CC, Fishman EK, Scott WW Jr. Tumoral calcinosis causing bone erosion in a renal dialysis patient. Clin Imaging. 1992;16:49-51. https://doi.org/10.1016/0899-7071(92)90091-M
  17. Lebl DR, Girardi FP. Isolated cervical spine facet joint tumoral calcinosis. Spine J. 2013;13:208-9. https://doi.org/10.1016/j.spinee.2012.11.029
  18. Eddington H, Hoefield R, Sinha S, et al. Serum phosphate and mortality in patients with chronic kidney disease. Clin J Am Soc Nephrol. 2010;5:2251-7. https://doi.org/10.2215/CJN.00810110
  19. Yamaguchi T, Sugimoto T, Imai Y, Fukase M, Fujita T, Chihara K. Successful treatment of hyperphosphatemic tumoral calcinosis with long-term acetazolamide. Bone. 1995;16(4 Suppl): 247S-50S. https://doi.org/10.1016/8756-3282(95)00019-A
  20. Mockel G, Buttgereit F, Labs K, Perka C. Tumoral calcinosis revisited: pathophysiology and treatment. Rheumatol Int. 2005;25:55-9. https://doi.org/10.1007/s00296-003-0387-z