Tumoral calcinosis appearances on skeletal scintigraphy

The authors report the case of a dialysis patient who progressively developed several soft tissue periarticular swellings, corresponding to tumoral calcinosis. This rare condition is the result of an unbalanced P-Ca product. It occurs in hemodialysis patients because of vitamin D intoxication (our patient's triggering factor) or, less frequently, secondary hyperparathyroidism. This patient presented with tumoral calcinosis of the right shoulder, right foot, and right fingers. These areas were visualized on Tc-99m HMDP imaging. He was treated with daily hemodialysis, aluminum hydroxide, Sevelamer, and the right foot and middle finger lesions were surgically removed. The right shoulder lesion was not operable because of deltoid muscle involvement.