Tumor-induced hypophosphatemia

Mulani, Manzura R.; Somani, Kiran; Bichu, Shrirang; Billa, Viswanath

doi:10.4103/0971-4065.179302

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…Of note, only three patients had a complete recovery after surgery [ 7 , 9 , 10 ]. This percentage is below that reported in the literature [ 15 ] emphasizing that occipital bone is a difficult location to approach and for which combined treatments might be necessary.…”

Section: Discussionmentioning

confidence: 99%

“…All other previously reported cases were initially treated by surgery. In one of them [ 9 ], surgery was performed after angioembolization. Histologically, all excised tumors were consistent with the phosphaturic mesenchymal tumor (PMT) [ 1 ].…”

Section: Literature Reviewmentioning

confidence: 99%

“…Histologically, all excised tumors were consistent with the phosphaturic mesenchymal tumor (PMT) [ 1 ]. In three patients [ 9 – 11 ], a postoperative drop of serum FGF23 was documented after surgery. The complete surgical removal of the tumor was obtained in three patients [ 7 , 9 , 10 ], with at least 3 months of follow-up for the two of them.…”

Section: Literature Reviewmentioning

confidence: 99%

“…In three patients [ 9 – 11 ], a postoperative drop of serum FGF23 was documented after surgery. The complete surgical removal of the tumor was obtained in three patients [ 7 , 9 , 10 ], with at least 3 months of follow-up for the two of them. Surgery was unsuccessful in one case [ 8 ].…”

Section: Literature Reviewmentioning

confidence: 99%

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Occipital bone and tumor-induced osteomalacia: a rare tumor site for an uncommon paraneoplastic syndrome

et al. 2023

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Introduction Tumor-induced osteomalacia (TIO) is an uncommon paraneoplastic syndrome due to the overproduction of fibroblast growth factor 23 (FGF23). It is predominantly caused by mesenchymal tumors and cured upon their complete removal. Non-surgical treatment is an alternative option but limited to specific clinical conditions. Methods We report a challenging case of TIO caused by a tumor involving the occipital bone. We also performed a literature review of TIO caused by tumors localized at this site, focusing on clinical findings, treatment, and outcomes. Results The patient, a 62-year-old male, presented with a long-lasting history of progressive weakness. Biochemical evaluation revealed severe hypophosphatemia due to low renal tubular reabsorption of phosphate with raised intact FGF23 values. A 68 Ga-DOTATATE PET/TC imaging showed a suspicious lesion located in the left occipital bone that MRI and selective venous catheterization confirmed to be the cause of TIO. Stereotactic gamma knife radiosurgery was carried out, but unfortunately, the patient died of acute respiratory failure. To date, only seven additional cases of TIO have been associated to tumors located in the occipital bone. Furthermore, the tumor involved the left side of the occipital bone in all these patients. Conclusion The occipital region is a difficult area to access so a multidisciplinary approach for their treatment is required. If anatomical differences could be the basis for the predilection of the left side of the occipital bone, it remains to be clarified.

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Section: Discussionmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

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Occipital bone and tumor-induced osteomalacia: a rare tumor site for an uncommon paraneoplastic syndrome

et al. 2023

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“…Then patients are often treated with calcium and phosphorus supplements. The lesion is not detected in the occipitocervical region until symptoms of nerve compression such as tinnitus[8] or a large mass occur. Our cases presented with a long-standing bone pain, headache and tongue de ection.…”

mentioning

confidence: 99%

Phosphaturic mesenchymal tumor of the occipitocervical region: Report of two rare cases and literature review

Zhang

Yan

et al. 2020

Preprint

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BackgroundTumor-induced osteomalacia (TIO) is regarded as a rare paraneoplastic syndrome mainly caused by phosphaturic mesenchymal tumor (PMT). To our known, only 5 occipitocervical PMTs have been described in the world’s English literature. We reported two rare cases of occipitocervical PMT, and conducted a retrospective analysis of these 7 cases. The purpose of this study is to discuss the clinical characteristics and treatment of occipitocervical PMT.Case PresentationBoth patients were middle-aged females, and had a long-standing bone pain. In case 1, there were no abnormalities in biochemical indicators. The blood phosphorus was normal and alkaline phosphatase (ALP) was elevated in case 2. Magnetic resonance imaging (MRI) suggested that osteolytic bone destruction accompanied by a soft tissue mass in left C1-2 vertebra (case 1). In case 2, the bone destruction was located on the right C1-2 and the clivus. Then both patients underwent complete resection of tumor, and case 2 also received adjuvant radiotherapy, the histopathology revealed a PMT. Case 2 suffered recurrence during 5-year follow-up.ConclusionsOccipitocervical PMT is quite rare, and only 5 cases have been reported in the literature. Currently, complete resection of the tumor is the best option. The surgery is difficult, and requires delicate operation due to the complex anatomy of the occipitocervical region. Postoperative radiotherapy has little effect on local control. And further research is needed to confirm the effectiveness of the newly-emerged therapies.

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Dietary modulations of folic acid affect the development of diethylnitrosamine induced hepatocellular carcinoma in a rat model

et al. 2021

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Tumor-induced hypophosphatemia

Cited by 4 publications

References 7 publications

Occipital bone and tumor-induced osteomalacia: a rare tumor site for an uncommon paraneoplastic syndrome

Occipital bone and tumor-induced osteomalacia: a rare tumor site for an uncommon paraneoplastic syndrome

Phosphaturic mesenchymal tumor of the occipitocervical region: Report of two rare cases and literature review

Dietary modulations of folic acid affect the development of diethylnitrosamine induced hepatocellular carcinoma in a rat model

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