Metastatic calcinosis as a rare manifestation of end-stage rental disease—a case report with review of the literature

Abstract

A consequence of end-stage renal disease (ESRD) is altered calcium and phosphate metabolism, and it often leads to higher risk of calcium deposition in the soft tissue. Calcinosis could be classified into metastatic, dystrophic, iatrogenic, and idiopathic. Metastatic calcification (MC) or metastatic calcinosis is the term given to abnormal deposition of calcified products in otherwise normal tissue, because of hyperphosphatemia, with or without hypercalcemia. Although hyperphosphatemia itself plays a key role in this process, hypercalcemia itself without hyperphosphatemia may not be enough to induce this process. MC mostly occurs in visceral organs such as kidneys, lungs, gastric mucosa, and even joints, skin, and eyes. However, MC rarely presents in the oral cavity. Herein, we present a rare case of metastatic calcification in a 57-year-old female secondary to ESRD. Clinically, there was a palpable hard mass in the anterior maxillary vestibule. The radiographic presentation was that of a large radiopaque mass in the anterior nasal spine and nasal septum. Histologically it showed amorphous, granular, calcified material. A detailed clinical, characteristic histopathologic feature along with a review of literature will be discussed.