Medical Treatment for Tumoral Calcinosis with Eight Years of Follow-up: A Report of Four Cases

Three females and one male aged 13 to 25 years and born to non-consanguineous parents presented with tumoral calcinosis. They presented with swellings on the extensor surfaces of their hips, shoulders, and/or elbows, with or without skin ulcers exuding milk-like fluid and scars from previous excisions. Their joint movements were generally free apart from mild limitation caused by skin ulceration or large masses. The masses were made up of calcified material surrounded by a dense fibrovascular reaction and occasional giant cells. Their serum uric acid, blood urea and creatinine, and creatinine clearance levels were all normal, but they had higher serum phosphorus and lower serum calcium levels. Phosphate-binding antacid was prescribed to lower the intestinal absorption of phosphorus, and their diets were adjusted to lower their phosphorus and calcium intake. After 2 years of treatment, their serum phosphorus levels dropped to, or near, normal levels. The lesions resolved completely in 2 of the patients but less so in the other 2 owing to interruption of their treatment. No recurrence, complications, or side effects were noted.