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Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 1901132010.5144/0256-4947.2008.469asm-6-469What's Your Diagnosis?A 56-year-old woman with starry radiopacities Wu Hsin-Chi Lin Shih-Hua From the Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROCCorrepondence and reprints: Shih-Hua Lin, MD, Division of Nephrology, Department of Medicine, Tri-Service General Hospital, Number 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan ROC, T: +886-2-87927213, F: +886-2-87927134, shihhualin@yahoo.comNov-Dec 2008 28 6 469 469 01 8 2008 Copyright © 2008, Annals of Saudi Medicine2008This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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A 56-year-old Chinese woman with end-stage renal disease (ESRD) on continuous ambulatory peritoneal dialysis for 3 years suffered from progressive bilateral hip pain for months due to tumoral calcinosis (periarticular soft tissue calcification). She received lanthanum carbonate 1 tablet three times daily (total 2250 mg) as a non-calcium phosphate binder for hyperphosphatemia-associated tumoral calcinosis (serum phosphate concentration 9.3 mg/dL) for 6 months. To evaluate whether the tumoral calcinosis was reduced or not, she received an x-ray examination which showed starry radiopacities scattered all over the abdomen (Figure 1).

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Figure 1 Abdominal roentgenogram shows widespread radiopaque spots in the lumen of gastro-intestinal tract and tumoral calcinosis over bilateral hip regions.