A rare cause of atraumatic fractures: case series of four patients with tumor-induced osteomalacia

Chen, Debbie; Clines, Gregory A.; Collins, Michael T.; Douyon, Liselle; Choksi, Palak

doi:10.1186/s40842-020-00101-8

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Причинами приобретенной гипофосфатемии могут быть ФО, повреждение почечных канальцев тяжелыми металлами или лекарственными препаратами (такими как аминогликозидные антибиотики), тяжелый хронический дефицит витамина D, первичный или вторичный гиперпаратиреоз [8]. В представленном клиническом случае описаны трудности диагностики и особенности лечения ФО.…”

Section: Discussionunclassified

Phosphopenic form of osteomalacia in a patient with FGF23 producing tumor

Pushkareva¹,

Bibik²,

Eremkina³

et al. 2022

Naučno-praktičeskaâ revmatologiâ

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Oncogenic osteomalacia is an orphan disease caused by the overproduction of fibroblast growth factor 23 (FGF23) in tumors, which leads to impaired bone matrix mineralization. Typical laboratory changes are hypophosphatemia, increased alkaline phosphatase, hyperphosphaturia, and decreased tubular phosphate reabsorption index. Surgery is the treatment of choice to eliminate an excessive production of FGF23. If surgical intervention is ineffective or impossible, preparations of phosphorus, calcium, vitamin D are prescribed. We present a clinical case of the stage-bystage diagnosis and treatment of the patient with chronic pain syndrome in the bones and multiple fractures.

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Section: Discussionunclassified

Phosphopenic form of osteomalacia in a patient with FGF23 producing tumor

Pushkareva¹,

Bibik²,

Eremkina³

et al. 2022

Naučno-praktičeskaâ revmatologiâ

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“…В 2013 г. ВОЗ выделила эти опухоли как «морфологически отличительные новообразования мягких тканей и костей, которые вызывают индуцированную опухолью остеомаляцию из-за чрезмерной продукции ФРФ-23». Удаление опухоли приводит к полному выздоровлению в короткие сроки, причем гомеостаз фосфора нормализуется уже в течение первой недели, а в некоторых случаях даже в первые три дня, но для полного восстановления минерализации требуется не менее года [15].…”

Section: Discussionunclassified

Vertebral Fractures as a Manifestation of Phosphaturic Mesenchymal Tumor-Induced Osteomalacia

Родионова

Buklemishev

Карпов

et al. 2021

Traumatology and Orthopedics of Russia

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Background. The rarity of the disease and, in this regard, the lack of doctors awareness about the pathology, late diagnosis and severe complications of the musculoskeletal system emphasize the relevance of clinical case demonstrating. The uniqueness of the case lies in the fact that hypophosphatemia, noted 3 years after the disease debut, was not taken into account.Case description. A 45-year-old patient with complaints of muscle weakness, gait disorders, torso deformity and multiple vertebral body fractures that appeared against the background of any somatic diseases absence, a differential diagnosis of metastatic vertebral bodies lesions and secondary osteoporosis complicated by vertebral body fractures was carried out for four years in various hospitals, and was even treated with bisphosphonates. Against this background, the chest deformity increased, kyphosis and remodeling fractures of other bones appeared. The assessment of calcium and phosphorus homeostasis was first performed at the 4th year of the disease, but the detected hypophosphatemia was not regarded as a manifestation of hypophosphatemic osteomalacia.Conclusion. Among adult patients with multiple low-energy fractures, severe muscle weakness and bone pain that appeared against the background of complete health, to exclude hypophosphatemic osteomalacia induced by mesenchymal tumor, it is necessary to include the level of phosphorus in blood and daily urine assessment in the diagnostic algorithm.

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Challenging case of tumour-induced osteomalacia

et al. 2022

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Tumour-induced osteomalacia (TIO), also known as oncogenic osteomalacia, is an uncommon paraneoplastic syndrome which poses a diagnostic challenge. The hallmark feature is severe acquired hypophosphataemic osteomalacia due to renal phosphate wasting because of increased secretion of fibroblast growth factor 23 (FGF-23). A man in his 30s, presented with a 4-year history of severe muscle aches, bone pain and proximal muscle weakness, was referred for evaluation. His laboratory examination revealed severe hypophosphataemia as a result of urinary phosphate wasting, low 1,25-dihydroxyvitamin D, high alkaline phosphatase and elevated FGF-23. We could localise the tumour to his right femur and the biopsy showed a mesenchymal origin. The treatment with pharmacotherapy and radiofrequency ablation helped in the normalisation of blood chemistry and resulted in significant clinical improvement. Hypophosphataemia, phosphaturia, elevated FGF-23 and low 1,25-dihydroxyvitamin D level with severe musculoskeletal pain and muscle weakness necessitate careful evaluation of TIO.

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A rare cause of atraumatic fractures: case series of four patients with tumor-induced osteomalacia

Cited by 3 publications

References 27 publications

Phosphopenic form of osteomalacia in a patient with FGF23 producing tumor

Phosphopenic form of osteomalacia in a patient with FGF23 producing tumor

Vertebral Fractures as a Manifestation of Phosphaturic Mesenchymal Tumor-Induced Osteomalacia

Challenging case of tumour-induced osteomalacia

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