Vertebral involvement in hyperphosphatemic tumoral calcinosis

Hyperphosphatemic tumoral calcinosis (HTC) is an inherited metabolic disord er characterized by calcified soft tissue masses and hyperphosphatemia. Bes ides these typical features, a number of less common manifestations have be en reported, all of them related to pathologic calcification of various tis sues. We have investigated the case of a woman with hyperphosphatemia, recu rrent episodes of lumbar pain, and a positive familial history of HTC, A bo ne scan showed markedly increased uptake in the lon er lumbar spine. Magnet ic resonance imaging showed pathological changes in L5 compatible with an i nflammatory reaction and not suggestive of neoplastic process. There was no evidence of infection, trauma, malignancy, or other disease that could cau se the lesion. We treated the patient with analgesics and NSAIDs and the pa in remitted over a period of 1 week, In a follow-up magnetic resonance imag ing 7 months later, the L5 lesion had disappeared completely, A computed to mography scan analysis with a bone window showed a sclerotic area at the L5 vertebral body. We believe that this patient was affected by the syndrome of HTC and that the inflammatory phenomena found in L5 are a manifestation of this disease. (Bone 28:316-318; 2001) (C) 2001 by Elsevier Science Inc. All rights reserved.