Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Hematology/Medical Oncology


Dr. Thomas Colletti


This is a case of a 43-year-old female with a history of metastatic neuroendocrine tumor (NET), diagnosed with calciphylaxis without the presence of renal failure, also known as nonuremic calciphylaxis (NUC). This is the first case report of NUC, or nonuremic calcific arteriolopathy, associated with a metastatic NET. NUC is a rare obliterative vasculopathy caused by calcium deposition within the lumen of small and medium sized blood vessels, which causes ischemia and necrosis of the skin, subcutaneous fat, visceral organs and skeletal muscle.1 Ulcerations are considered the hallmark presentation, though non-ulcerated plaques are becoming more common.2 Studies suggest a mortality rate of 33 percent at six months in patients with non-ulcerated plaques; ulceration increases the risk of death to over 80 percent with sepsis being the leading cause of death.2,3 Given the high morbidity and mortality associated with NUC, this case illustrates the importance of recognition, timely diagnosis and a multidisciplinary approach in order to improve patient outcomes.


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