Clinical and Bone Density Outcomes of Tumor-Induced Osteomalacia after Treatment
| Autor: | Michael D. Whitaker, Curtiss B. Cook, E. Peter Bosch, Lisa G. Umphrey |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Bone density Paraneoplastic Syndromes Endocrinology Diabetes and Metabolism Radiography Urology Soft Tissue Neoplasms Disability Evaluation Endocrinology Lumbar Bone Density Fractures Compression medicine Humans Mesenchymoma Neoplasm Mixed tumor Osteomalacia Muscle Weakness medicine.diagnostic_test business.industry Magnetic resonance imaging Recovery of Function General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Fibroblast Growth Factors Fibroblast Growth Factor-23 Mixed Tumor Malignant Positron-Emission Tomography business After treatment |
| Zdroj: | Endocrine Practice. 13:458-462 |
| ISSN: | 1530-891X |
| Popis: | Objective To report the outcomes of tumor-induced osteomalacia after treatment, particularly related to recovery of bone mass. Methods We review the clinical course of a 61-year-old man extremely debilitated from multiple fractures and neuromuscular weakness due to tumor-induced osteomalacia and report the changes in biochemical markers and bone density after removal of the causative neoplasm. Results At the time of diagnosis, the patient’s serum phosphorus and 1,25 dihydroxyvitamin D levels were depressed, and his fibroblast growth factor-23 level was markedly elevated. These values normalized 2 days after surgery and remained within their respective reference ranges 4 and 12 months after resection of a mesenchymal tumor. Lumbar bone density values (T-scores) were 0.445 g/cm2 (-5.9) preoperatively, 0.939 g/cm2 (–1.4) 4 months after surgery, and 1.152 g/cm2 (0.7) 12 months after surgery. Left femoral neck values at the same time points were 0.525 g/cm2 (-3.0), 1.035 g/cm2 (-0.8), and 1.184 g/cm2 (1.9). Ultra-distal radius values at the same time points were 0.128 g/cm2 (-7.0), 0.191 g/cm2 (-5.9), and 0.259 g/cm2 (-4.8). In addition, he recovered neuromuscular function and was able to leave his wheelchair. Conclusion Tumor-induced osteomalacia can be an extremely debilitating disease. With successful localization, identification, and resection of the neoplasm, bone mass and physical function can recover. (Endocr Pract. 2007;13:458-462) |
| Databáze: | OpenAIRE |
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