Hyperphosphatemic tumoral calcinosis: a 10-year follow-up

Area of Science:

• Endocrinology
• Nephrology
• Dermatology

Background:

• Primary hyperphosphatemic tumoral calcinosis (TC) is a rare condition characterized by ectopic calcification.
• Effective long-term treatment strategies for TC remain elusive.

Observation:

• A case of primary hyperphosphatemic TC in an 18-year-old male is presented with a 10-year follow-up.
• The patient underwent multiple surgeries and medical treatments without halting lesion progression.
• Physical examination revealed extensive calcified masses, with normal levels of PTH, calcitonin, vitamins D, renal and liver function, electrolytes, alkaline phosphatase, calcium, and magnesium.

Findings:

• Serum phosphorus was elevated, and C-terminal FGF-23 levels were significantly high (1960 RU/mL).
• Radiological and histological studies confirmed the diagnosis of TC.
• The case underscores the progressive and recurrent nature of calcified masses in hyperphosphatemic TC.

Implications:

• This long-term follow-up emphasizes the significant morbidity and treatment difficulties associated with primary hyperphosphatemic TC.
• The identification of FGF-23 as a key factor in hyperphosphatemic TC offers potential targets for future therapeutic interventions.
• Further research into FGF-23-targeted therapies is warranted for improved patient outcomes.