Hypophosphatemic osteomalacia induced by FGF23-secreting tumor of the left femur

Родионова, С. С.; Снетков, А. И.; Акиньшина, А. Д.; Булычева, И. В.; Торгашин, А Н; Grebennikova, T. A.; Белая, Ж. Е.; Agafonova, E.; Торопцова, Н. В.; Никитинская, О. А.

doi:10.14412/1995-4484-2019-708-712

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…Ретроспективный анализ 144 случаев онкогенной остеомаляции выявил первоначальный ошибочный диагноз в 95,1% случаев [1]. Как свидетельствуют данные литературы [2] и наши собственные наблюдения, причиной ошибочного диагноза является недостаточная осведомленность врачей о патологии.…”

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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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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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“…Folpe описано всего около 450 случаев, но истинная встречаемость остается неизвестной [1]. В Российской Федерации описания ФМО единичны [16][17][18][19]. Чаще всего ФМО обнаруживаются у пациентов среднего возраста [4,20], при этом самый ранний дебют заболевания описан у девятимесячного ребенка [21], гендерные различия не выявлены (М:Ж = 1,25:1 [22]).…”

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The case of oncogenic hypophosphatemic osteomalacia

Eremkina¹,

Mirnaya²,

Горбачева³

et al. 2020

Obes. metabol.

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Osteomalacia is a systemic bone disease, characterized by an excessive accumulation of non-mineralized osteoid and an imbalance in the organic matrix formation and mineralization. A rare cause of disease is tumor-induced osteomalacia, most often due to phosphaturic mesenchymal tumors (PMT). Usually there are benign small tumors, affecting the soft tissues and bones of any location. The basic pathogenesis of underlying oncogenic osteomalacia is a decreased renal tubular reabsorption of phosphate consequent to hyperproduction of fibroblast growth factor 23 in PMT. Clinical features are nonspecific, the average period from the symptoms onset to diagnosis reaches 3 years and at least 5 years before surgical treatment. Finding the tumour is crucial, as complete removal is curative. We present a clinical case of tumor-induced osteomalacia due to PMT required the complex differential diagnosis with other rare diseases.

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A clinical case of phosphopenic osteomalacia due to paraneoplastic secretion of metastatic prostate cance

et al. 2023

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Phosphaturic mesenchymal tumor can cause osteomalacia due to excessive secretion of fibroblast growth factor 23 (FGF23), which disrupts the metabolism of phosphate and vitamin D. These tumors are predominantly benign, but less than 5% of them are malignant forms. This article presents the first clinical case in the Russian Federation of a 69-year-old patient with severe hypophosphatemia due to metastatic prostate cancer. Increased secretion of FGF23 are described in the androgen-resistent prostate cancer, which led to pronounced disorders of mineral metabolism, accompanied by a clinical symptom of weakness, pain in the bones, immobilization of the patient. The condition was regarded as worsening against the background of the progression of the disease. However, symptomatic therapy aimed at increasing the level of phosphate significantly improved the patient’s general condition. The medical community should be aware of the possibility of developing hypophosphatemia in patients with weakness and bone pain, which are not always associated with the progression of metastatic prostate cancer.

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Hypophosphatemic osteomalacia induced by FGF23-secreting tumor of the left femur

Cited by 6 publications

References 11 publications

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

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

The case of oncogenic hypophosphatemic osteomalacia

A clinical case of phosphopenic osteomalacia due to paraneoplastic secretion of metastatic prostate cance

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