Huge tumoral calcinosis of the buttock

Tumoral calcinosis (TC) is a rare neoplasm-like condition that can be sporadic, familial, or secondary to other diseases. The treatment of different types of TC may differ based on the etiology. In certain situations such as intolerable pain due to involvement of local tissue, repeated skin ulceration, or fistula formation, surgical excision is unavoidable. This case report aims to share the rare condition. A brief review is also presented, including the pathogenesis and current management strategies of TC. We report a rare case of TC secondary to end-stage renal disease in a 65-year-old female patient presenting with a huge, painful, buttock area tumor involving the sacrum that required extensive surgical excision and gluteus maximus myocutaneous flap reconstruction. Complete resolution was achieved after a wide surgical excision followed by local flap reconstruction and medical control. Surgical excision alone may result in a high recurrence rate when TC is secondary to other diseases. Combination with medical treatment to achieve phosphate deprivation is more effective.