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A Rare Case of Phosphaturic Tumor/Oncogenic Osteomalacia - Diagnostic Challenges and Management Algorithm
INTRODUCTION: Oncogenic osteomalacia is a rare paraneoplastic syndrome of acquired hypophosphatemic osteomalacia, resulting from a deficit in renal tubular phosphate reabsorption, in which fibroblast growth factor 23 seems to be implicated. CASE REPORT: A 42-year-old male presented with complaints o...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Indian Orthopaedic Research Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6588137/ https://www.ncbi.nlm.nih.gov/pubmed/31245319 http://dx.doi.org/10.13107/jocr.2250-0685.1304 |
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author | Shenbaghavalli, T. Harshavardhan, J. K. Giriraj Menon, P. Gopinath |
author_facet | Shenbaghavalli, T. Harshavardhan, J. K. Giriraj Menon, P. Gopinath |
author_sort | Shenbaghavalli, T. |
collection | PubMed |
description | INTRODUCTION: Oncogenic osteomalacia is a rare paraneoplastic syndrome of acquired hypophosphatemic osteomalacia, resulting from a deficit in renal tubular phosphate reabsorption, in which fibroblast growth factor 23 seems to be implicated. CASE REPORT: A 42-year-old male presented with complaints of low back pain for the past 4 years and inability to walk for the past 3 years. Blood investigations showed hypophosphatemia and elevated serum alkaline phosphatase. Radiographs and magnetic resonance imaging revealed features of osteomalacia. DOTONAC PET-computed tomography (CT) showed a lesion in the greater trochanter suggestive of a phosphaturic mesenchymal tumor. CT-guided biopsy of the lesion was done which confirmed the diagnosis. The tumor was resected by intralesional methods (burring and cementation) with correction of hypophosphatemia by oral phosphorus supplementation. Patient clinically improved and was able to walk with support at the time of discharge. CONCLUSION: Phosphaturic tumor was localized to be in the posterior aspect of the right greater trochanter. To find the tumor was a major diagnostic challenge involving various diagnostic modalities. The occurrence of such a condition is rare and it may take even years to correctly diagnose the disease. |
format | Online Article Text |
id | pubmed-6588137 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Indian Orthopaedic Research Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-65881372019-06-26 A Rare Case of Phosphaturic Tumor/Oncogenic Osteomalacia - Diagnostic Challenges and Management Algorithm Shenbaghavalli, T. Harshavardhan, J. K. Giriraj Menon, P. Gopinath J Orthop Case Rep Case Report INTRODUCTION: Oncogenic osteomalacia is a rare paraneoplastic syndrome of acquired hypophosphatemic osteomalacia, resulting from a deficit in renal tubular phosphate reabsorption, in which fibroblast growth factor 23 seems to be implicated. CASE REPORT: A 42-year-old male presented with complaints of low back pain for the past 4 years and inability to walk for the past 3 years. Blood investigations showed hypophosphatemia and elevated serum alkaline phosphatase. Radiographs and magnetic resonance imaging revealed features of osteomalacia. DOTONAC PET-computed tomography (CT) showed a lesion in the greater trochanter suggestive of a phosphaturic mesenchymal tumor. CT-guided biopsy of the lesion was done which confirmed the diagnosis. The tumor was resected by intralesional methods (burring and cementation) with correction of hypophosphatemia by oral phosphorus supplementation. Patient clinically improved and was able to walk with support at the time of discharge. CONCLUSION: Phosphaturic tumor was localized to be in the posterior aspect of the right greater trochanter. To find the tumor was a major diagnostic challenge involving various diagnostic modalities. The occurrence of such a condition is rare and it may take even years to correctly diagnose the disease. Indian Orthopaedic Research Group 2019 /pmc/articles/PMC6588137/ /pubmed/31245319 http://dx.doi.org/10.13107/jocr.2250-0685.1304 Text en Copyright: © Indian Orthopaedic Research Group http://creativecommons.org/licenses/by-nc/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Shenbaghavalli, T. Harshavardhan, J. K. Giriraj Menon, P. Gopinath A Rare Case of Phosphaturic Tumor/Oncogenic Osteomalacia - Diagnostic Challenges and Management Algorithm |
title | A Rare Case of Phosphaturic Tumor/Oncogenic Osteomalacia - Diagnostic Challenges and Management Algorithm |
title_full | A Rare Case of Phosphaturic Tumor/Oncogenic Osteomalacia - Diagnostic Challenges and Management Algorithm |
title_fullStr | A Rare Case of Phosphaturic Tumor/Oncogenic Osteomalacia - Diagnostic Challenges and Management Algorithm |
title_full_unstemmed | A Rare Case of Phosphaturic Tumor/Oncogenic Osteomalacia - Diagnostic Challenges and Management Algorithm |
title_short | A Rare Case of Phosphaturic Tumor/Oncogenic Osteomalacia - Diagnostic Challenges and Management Algorithm |
title_sort | rare case of phosphaturic tumor/oncogenic osteomalacia - diagnostic challenges and management algorithm |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6588137/ https://www.ncbi.nlm.nih.gov/pubmed/31245319 http://dx.doi.org/10.13107/jocr.2250-0685.1304 |
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