Tumor-induced osteomalacia treated with T12 tumor resection.
Alyssa J ManciniAmin SabetGunnlaugur Petur NielsenJ Anthony ParkerJoseph H SchwabAshley WardJim S WuAlan Ona MalabananPublished in: Endocrinology, diabetes & metabolism case reports (2022)
Tumor-induced osteomalacia (TIO) is typically caused by phosphaturic mesenchymal tumors (PMTs) that are usually found in the soft tissue of the extremities and bone of the appendicular skeleton/cranium and rarely in the spine. TIO may be misdiagnosed as osteoporosis or spondyloarthritis, and the correct diagnosis is often delayed for years. However, osteoporosis, in the absence of fracture, is not associated with bone pain. The hallmark of TIO is hypophosphatemia with inappropriately normal or low 1,25-dihydroxyvitamin D and elevated or inappropriately normal fibroblast growth factor-23 (FGF23) levels. In patients with unexplained persistent bone pain, a serum phosphate should be measured. Consider PMT-associated TIO as a potential cause of unexplained persistent bone pain and hypophosphatemia. PMTs express somatostatin receptors and may be identified with 68Ga-DOTATATE imaging. Complete surgical resection is the preferred treatment for spinal PMTs associated with TIO.
Keyphrases
- soft tissue
- bone mineral density
- chronic pain
- postmenopausal women
- quantum dots
- visible light
- pain management
- pet ct
- neuropathic pain
- bone loss
- body composition
- high glucose
- stem cells
- diabetic rats
- bone regeneration
- drug induced
- spinal cord
- oxidative stress
- rheumatoid arthritis
- postoperative pain
- neuroendocrine tumors