Successful Treatment of Tumor-Induced Osteomalacia due to an Intracranial Tumor by Fractionated Stereotactic Radiotherapy

Tarasova, Valentina; Trepp-Carrasco, Alejandro G.; Thompson, Robert B.; Recker, Robert R.; Chong, Wai Po; Collins, Michael T.; Armas, Laura A.G.

doi:10.1210/jc.2013-2528

Cited by 42 publications

(30 citation statements)

References 16 publications

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“…Surgical treatment is traditionally considered as the gold standard 6 , although there are several medical approaches available for patients with tumor-induced osteomalacia, including phosphorus and calcitriol supplementation 1 , cinacalcet 7 , octreotide 8 , beam radiation 9,10 , chemotherapy 11,12 , and radiofrequency ablation 13 . Long-term phosphorus and calcitriol supplementation may have risks of hyperparathyroidism, nephrocalcinosis, and nephrolithiasis 6 .…”

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confidence: 99%

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Surgical Treatments of Tumor-Induced Osteomalacia Lesions in Long Bones

Wang

Zhong

Liu

et al. 2015

The Journal of Bone and Joint Surgery

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confidence: 99%

“…Long-term phosphorus and calcitriol supplementation may have risks of hyperparathyroidism, nephrocalcinosis, and nephrolithiasis 6 . There is limited evidence documenting the roles of other medical treatments.…”

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confidence: 99%

Surgical Treatments of Tumor-Induced Osteomalacia Lesions in Long Bones

Wang

Zhong

Liu

et al. 2015

The Journal of Bone and Joint Surgery

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“…In such cases, medical therapy with phosphorus supplementation and calcitriol is critical to prevent the potentially debilitating effects of hypophosphatemia (6). There are also case reports of successful use of radiofrequency ablation for incompletely resected tumors or in cases where surgical morbidities were deemed too great (14)(15)(16). Additionally, there is a potential role for the use of a monoclonal antibody against FGF23 in cases of unidentified tumors.…”

Section: Discussionmentioning

confidence: 99%

Oncogenic Osteomalacia: The Search, Treatment, and Cure of a Debilitating Tumor

Lee

Mathew

Holick

2018

AACE Clinical Case Reports

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Objective: To present a rare case of oncogenic osteomalacia, describe the breadth of potential clinical symptoms, and review the underlying pathophysiology of this disorder. Methods: We report a case of oncogenic osteomalacia cured by surgical resection of a mesenchymal tumor. Results: A 48-year-old, wheelchair-dependent man presented to a tertiary care academic hospital with progressive back pain and diffuse weakness. Biochemical evaluation revealed elevated alkaline phosphatase, marked hypophosphatemia, phosphaturia, vitamin D deficiency, and elevated fibroblast growth factor 23, results that are concerning for oncogenic osteomalacia. Subsequent imaging showed extensive loss of vertebral height, numerous fractures, and ultimately identified an area suspicious for tumor in the right mandible, with concurrent uptake on octreotide scan. Segmental resection of the right mandible revealed a calcifying mesenchymal tumor. Following surgery there was a normalization of biochemistries and dramatic improvement in the patient's symptoms. Conclusion: Oncogenic osteomalacia is a rare and often confounding diagnosis. Identification may be aided by the relatively recently characterized hormone fibroblast growth factor 23. Identification of this paraneoplastic syndrome is critical, as surgical intervention has curative potential for possible debilitating symptoms. (AACE Clinical Case Rep. 2018;4:e300-e304) Abbreviations: 1,25(OH) 2 D = 1,25-dihydroxyvitamin D; 25(OH)D = 25-hydroxyvitamin D; FGF23 = fibroblast growth factor 23; iPTH = intact parathyroid hormone; MRI = magnetic resonance imaging; TIO = tumor-induced osteomalacia e304 Debilitating Oncogenic Osteomalacia, AACE Clinical Case Rep. 2018;4(No. 4) Copyright © 2018 AACE with consequent hypophosphatemia, myopathy, and osteomalacia. The disorder is important to recognize as surgical removal of the offending tumor can rapidly reverse the biochemical and clinical manifestations of the disease.

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“…Intracranial FGF23-producing PMTMCT is extremely rare and, to the best of our knowledge, only 17 cases have been reported in the literature to date (Table 1) [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. It tends to affect sterically complicated areas such as the anterior skull base.…”

Section: Discussionmentioning

confidence: 99%