Abstract | INTRODUCTION: OBSERVATION: A 70-year-old female patient was admitted to explore diffuse pain caused by multiple fractures secondary to osteomalacia. Despite vitamin D supplementation, she remained profoundly hypophosphoremic with major renal phosphaturia. A tumor-induced mechanism was suspected because of high level of FGF-23. It took more than three years of investigation to spot the causal phosphaturic mesenchymal tumor despite annual repetition of indium-labelled scintigraphy and PET-scan. The resection of the tumor, located between two phalanges of the right foot, cured the patient with sustained normal rate of serum level of phosphorus after two years. CONCLUSION:
Tumor-induced osteomalacia is a diagnostic challenge because the localization of the tumor may be a long process. Patients should be monitored clinically and imaging studies repeated until a diagnosis is made and the causal tumor removed.
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Authors | T Chazal, V Khanine, O Lidove, S Godot, J-M Ziza |
Journal | La Revue de medecine interne
(Rev Med Interne)
Vol. 38
Issue 6
Pg. 412-415
(Jun 2017)
ISSN: 1768-3122 [Electronic] France |
Vernacular Title | Ostéomalacie secondaire à une tumeur mésenchymateuse phosphaturique de révélation tardive. |
PMID | 27659744
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved. |
Topics |
- Aged
- Delayed Diagnosis
- Female
- Fibroblast Growth Factor-23
- Foot
- Humans
- Hypophosphatemia
(complications)
- Hypophosphatemia, Familial
(diagnosis, etiology)
- Mesenchymoma
(complications, diagnosis)
- Neoplasms, Connective Tissue
(diagnosis, etiology)
- Osteomalacia
- Paraneoplastic Syndromes
- Soft Tissue Neoplasms
(complications, diagnosis)
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