고관절 주변에 발생한 요독성 종양성 석회증
Uremic Tumoral Calcinosis around the Hip Joint in a Patient on Hemodialysis
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초록
종양성 석회증은 고관절, 견관절, 주관절과 같은 큰 관절 주변의 연부조직에 칼슘염이 침착되는 매우 드문 질환이다. 발생원인에 대하여는 아직까지 명확하게 밝혀진 바는 없으나 신장의 근위 세뇨관에서 인의 대사 장애가 원인이라는 가설이 있고, 만성 신질환이나 부갑상선 기능항진증과 같은 질환이 원인이 될 수도 있다. 혈액 투석을 하는 만성 신부전 환자에서 발생한 속발성 종양성 석회증, 이른바 요독성 종양성 석회증에 대해 수술적 절제술 후 결과에 대하여 보고한 예는 국내에서는 없는 실정이다. 저자들은 고관절부 주위 종괴를 주소로 내원한, 혈액 투석 중인 57세 여자 환자에서 단순 방사선, 자기공명영상 및 전산화단층 촬영상 요독성 종양성 석회증을 진단하고 절제술 후 추시하여 임상적으로 만족할 만한 결과를 얻었기에 문헌고찰과 함께 보고하고자 한다.
Abstract
The term tumoral calcinosis in used to describe the deposition of nodular calcareous masses in the soft tissue around large joints, such as the hips, shoulders, and elbows. Although the cause has not yet been clearly determined, according to the hypothesis, failure of phosphorus metabolism in the proximal tubule in kidney, chronic renal disease and hyperparathyroidism may cause tumoral calcinosis. No cases of tumoral calcinosis treated with surgical resection in chronic renal failure patients on hemodialysis, so called uremic tumoral calcinosis, have been reported in Korea. The authors experienced the case of a 57-year-old woman with chronic kidney disease on hemodialysis who presented with a mass around the hip. We made a diagnosis using plainradiographs, magnetic resonance imaging, and computed tomography of tumoral calcinosis, and treated the patient successfully with surgical resection. We report on a case of uremic tumoral calcinosis with a review of the literature.
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