Tumoral calcinosis complicating CKD-MBD in hemodialysis: a case report

Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a common complication in patients with chronic kidney failure and is frequently associated with ectopic calcification. One of its less frequent manifestations, tumoral calcinosis (TC), involves periarticular soft tissue deposition of calcium-phosphate complexes and may develop in patients undergoing maintenance dialysis for end-stage renal disease. TC contributes to significant morbidity, including pain and functional impairment, and may be associated with increased mortality. This report describes a patient receiving maintenance hemodialysis who developed calcified periarticular masses in the left hip and right shoulder. The diagnosis of secondary TC related to CKD-MBD was established based on laboratory parameters, radiographic imaging, and histopathological evaluation. Management included surgical excision of the lesions, dietary phosphate restriction, administration of non-calcium-based phosphate binders, use of low-calcium dialysate, and initiation of high-flux hemodialysis. These therapeutic measures were associated with gradual reduction in lesion size and symptomatic improvement.