REGRESSION OF MASSIVE TUMORAL CALCINOSIS OF THE ISCHIUM IN A DIALYSISPATIENT AFTER TREATMENT WITH REDUCED CALCIUM DIALYSATE AND IV ADMINISTRATION

Background: Tumoral calcinosis, an inherited metabolic disorder, has b een described with increasing frequency over the last 20 years [Drueke 1966]. It is characterized by massive calcium phosphate deposits in p eriarticular tissues, usually around large joints, especially the hips , knees and elbows (editorial in Lancet 1987). Patient and method: We describe a 58-year-old male patient with tumoral calcinosis of the isc hium and severe hyperparathyroid bone disease, successfully treated wi th reduced calcium dialysate and vitamin D. Conclusion: We believe tha t in cases of tumoral calcification with histologically proven hyperpa rathyroid bone disease, lowering the calcium dialysate concentration t ogether with careful administration of vitamin analogs and monitoring of serum calcium, phosphate and parathyroid hormone levels, may be the ideal therapeutic approach. Control of hyper phosphatemia would be be st achieved with measures other than administration of aluminium phosp hate binders if one wishes to avoid the induction of adynamic bone.