Tumor-induced osteomalacia and the regulation of phosphate homeostasis

Kumar, Rajiv

doi:10.1016/s8756-3282(00)00334-3

Cited by 139 publications

(90 citation statements)

References 55 publications

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“…Additionally, the clinical utility of FGF-23 and diagnosis of tumor-induced osteomalacia has been well established in scientific research [1,8,10,21]. FGF-23 is secreted by oncogenic cells and acts in the kidney to decrease phosphate reabsorption, leading to osteomalacia [11]. Systemic levels of FGF-23 were useful for the patients who received it preoperatively and levels were elevated in both cases.…”

Section: Discussionmentioning

confidence: 99%

The Phosphaturic Mesenchymal Tumor: Why is Definitive Diagnosis and Curative Surgery Often Delayed?

Ledford

Zelenski

Cardona

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Tumor-induced osteomalacia is a paraneoplastic syndrome resulting in renal phosphate wasting and decreased bone mineralization. Phosphaturic mesenchymal tumors represent a rare etiology of tumor-induced osteomalacia. Nonspecific symptoms of fatigue, bone pain, and musculoskeletal weakness make the diagnosis elusive and lead to a delay in surgical treatment. Questions/purposes In this case series, the following three questions were asked: (1) How do the clinical presentation and features of phosphaturic mesenchymal tumors delay the diagnosis? (2) What is the clinical course after surgical treatment of phosphaturic mesenchymal tumors? (3) How frequently do phosphaturic mesenchymal tumors recur and are there factors associated with recurrence?Methods This study retrospectively reviewed the cases of five adults diagnosed and treated for phosphaturic mesenchymal tumors. Patients were identified through an internal orthopaedic oncology database with clinical, surgical, and histologic data obtained through a systematic chart review. Results Five patients presented with a long-standing history of osteomalacia, generalized fatigue, pain, and weakness before the diagnosis was reached at an average of 7.2 years (range, 2-12 years) after initial symptom onset. The diagnosis appeared to be delayed owing to the cryptic medical presentation, difficulty in locating tumor by imaging, and confirming histologic appearance. Two patients treated with wide surgical resection did not experience recurrence compared with three patients who did show recurrent signs and symptoms after marginal excision. A postoperative increase in fibroblast-derived growth factor-23 was associated with recurrent disease. Conclusions Although uncommon, the diagnosis of phosphaturic mesenchymal tumor should be considered in any patient who presents with hypophosphaturic osteomalacia and no other physiologic cause. Definitive treatment is early, wide surgical resection. Level of Evidence Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

The Phosphaturic Mesenchymal Tumor: Why is Definitive Diagnosis and Curative Surgery Often Delayed?

Ledford

Zelenski

Cardona

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…The action of FGF-23 is not blocked by PTH receptor antagonists, suggesting that it acts independently from cyclic AMP. 13,14,33,34 Inactivation of the Klotho protein relates to several aging phenomena, such as thymus atrophy, sterility, pulmonary emphysema, ataxia, skin atrophy, muscle loss, and osteopenia. 35 Recent data have also indicated a relation between Klotho protein and mineral metabolism, vitamin D, insulin/glucose, oxidative stress, and vascular calcifications.…”

Section: Production and Mechanisms Of Action Of Fgf-23mentioning

confidence: 99%

FGF-23: estado da arte

Oliveira

Moysés

2010

J. Bras. Nefrol.

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Approximately 10 years ago, a member of the family of the fibroblast growth factors, the hormone FGF-23 (fibroblast growth factor 23) was discovered. Its currently known functions involve phosphorus (P) metabolism and inhibition of 1α hydroxylase, the enzyme responsible for the synthesis of calcitriol. That discovery led to a better understanding of the mechanisms of P control, an element associated with mortality, especially in chronic kidney disease. This study reviews several aspects of that hormone, such as its discovery, function, production, mechanism of action, and the most recent clinical studies about it. Afterwards, a discussion about the possible effects of those studies on clinical practice will be presented.

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“…This had to be corrected by either a split or a complete tibialis anterior tendon transfer. Complications in the form of pin track infection (less than 1%), frame loosening (1 case) and over correction of the hind foot deformity in two patients (1 spontaneously corrected Introduction Tumor-induced osteomalacia (TIO) in children is an extrem rare disease [2,3]. Less than 20 cases have been reported in the literature [4].…”

Section: Locked Plating As a Treatment Option In Paediatric Orthopaedmentioning

confidence: 99%

“…Introduction According to Ponseti the treatment of congenital clubfoot comprises a well-defined continuous full-leg cast application of the lower extremities [1,2]. Depending on the severity of the equinus deformity an achillotenotomy (AT) is performed [3].…”

mentioning

confidence: 99%

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The 23rd Annual Meeting of Children's Orthopaedics (VKO), Ulm, March 20–21, 2009

2009

Journal of Children's Orthopaedics

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Tumor-induced osteomalacia and the regulation of phosphate homeostasis

Cited by 139 publications

References 55 publications

The Phosphaturic Mesenchymal Tumor: Why is Definitive Diagnosis and Curative Surgery Often Delayed?

The Phosphaturic Mesenchymal Tumor: Why is Definitive Diagnosis and Curative Surgery Often Delayed?

FGF-23: estado da arte

The 23rd Annual Meeting of Children's Orthopaedics (VKO), Ulm, March 20–21, 2009

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