Tumor‐induced Osteomalacia: A Case Report and Etiological Analysis with Literature Review

Autor: Zhenhao Zhang, Jiaxin Li, Zhicai Zhang, Zengwu Shao
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Orthopaedic Surgery, Vol 15, Iss 12, Pp 3342-3352 (2023)
Druh dokumentu: article
ISSN: 1757-7861
1757-7853
DOI: 10.1111/os.13901
Popis: Background Tumor‐induced osteomalacia (TIO) belongs to a rare disease of the paraneoplastic syndrome. Phosphate uric mesenchymal tumor (PMT) is the most common cause of TIO, while the possibility of other tumors cannot be excluded. Case presentation We present a case of a 36‐year‐old female patient with systemic skeletal abnormalities. The woman complained of low back pain with mild motor dysfunction for 2 years. Laboratory examination showed abnormalities in markers of bone metabolism, parathyroid hormone (PTH), vitamin D and serum phosphorus. Pooled imaging examination indicated extension abnormalities in the skeletal system and a single lesion in the right femoral head. The lesion of the right femoral was imaging with somatostatin receptor‐positive, which was highly suggestive of a single neuroendocrine tumor. CT guided right femoral tumorectomy and bone grafting were performed when medical treatment failed. Postoperative pathological diagnosis was phosphate urinary mesenchymal tumor secreting fibroblast growth factor 23 (FGF23), which accorded with pre‐operative expectations. The postoperative symptoms were effectively relieved, and indicators returned to normal. Conclusion The tumors causing TIO exhibited significant heterogeneity in terms of tissue origin, pathological characteristics and biological behavior, but the unique common characteristic is the secretion of FGF23. With significant progress in diagnosis and treatment, the clinical follow‐up of most TIO patients shows a good prognosis, but the prognosis of those with malignant tumors is relatively poor.
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