#850 Tumor-like calcification in patients undergoing haemodyalisis

Abstract

Abstract Background and Aims Tumor-like calcinosis is a condition where calcium phosphate crystals accumulate in the tissues around joints, forming large, calcified masses. Although the exact mechanisms are not fully understood, it is believed that an elevated calcium-phosphate product and severe hyperparathyroidism play key roles in its development. While surgery is commonly suggested for treatment, there remains ongoing debate regarding the best approach. Method We describe a 63-year-old diabetic patient on long-term hemodialysis who presented with a six-month history of worsening left hip pain and limited mobility. A CT scan was performed, revealing a calcified mass in the posterior thigh. Laboratory tests were conducted, which showed elevated calcium-phosphate levels and hyperparathyroidism, supporting the diagnosis of tumor-like calcinosis. The patient's condition was evaluated, and due to the mass's close proximity to vascular and nerve structures, surgical removal was considered unfeasible. A conservative management approach was adopted, which included angioplasty to improve blood flow and alleviate symptoms. Results The CT scan findings suggested the calcified mass was causing sharp, electric-shock-like pain and compressing the superficial femoral artery, leading to critical limb ischemia. Angioplasty temporarily improved blood flow and provided symptom relief, but the patient continued to experience persistent pain and functional limitations. The rarity of tumor-like calcinosis in hemodialysis patients, combined with the calcified masses, posed significant challenges in both diagnosis and treatment. Conclusion This case highlights the diagnostic and treatment challenges of tumor-like calcinosis in chronic hemodialysis patients. Despite conservative management, the patient experienced persistent pain and functional impairment. Endovascular intervention, including double dilation with stenting, temporarily restored blood flow and relieved symptoms. However, this approach is not curative and carries a risk of rethrombosis. The complexity of managing calcinosis-related vascular complications in hemodialysis patients calls for further investigation into optimal treatment strategies for such rare cases.