Hemiarthroplasty for tumor-induced osteomalacia caused by tumor localized in femoral head: a case report.
Sayaka AritaTomofumi NsihinoYuki MitaniKotaro SakashitaSho TotsukaRyunosuke WatanabeHajime MishimaHitomi KawaiDaisuke MatsubaraYoshionao OdaMasashi YamazakiPublished in: Journal of surgical case reports (2022)
Tumor-induced osteomalacia (TIO) is a rare tumor-associated syndrome in which osteomalacia is induced by a tumor. A 67-year-old male patient presented for the first time with low back pain, weakness of the lower extremities and difficulty in walking. Six years earlier, he had nonspecific symptoms such as low back pain, and blood tests showed high alkaline phosphatase and low phosphorus. In addition, fibroblast growth factor 23 (FGF23) was abnormally high at 454 pg/mL. A diagnosis of FGF23-related hypophosphatemic osteomalacia was made. Somatostatin receptor scintigraphy, venous sampling and MRI were performed to localize and diagnose TIO. The tumor was found to be confined to the right femoral head and hemiarthroplasty was performed. Pathological examination revealed a phosphaturic mesenchymal tumor. Postoperatively, symptoms and blood test data improved. Although resection of the lesion and osteochondral transplantation or total hip arthroplasty were considered, hemiarthroplasty was chosen over concerns about treatment failure due to seeding.
Keyphrases
- total hip arthroplasty
- stem cells
- bone marrow
- high glucose
- oxidative stress
- machine learning
- magnetic resonance
- endothelial cells
- diabetic rats
- quantum dots
- depressive symptoms
- hip fracture
- electronic health record
- sleep quality
- smoking cessation
- data analysis
- artificial intelligence
- heavy metals
- neuroendocrine tumors
- combination therapy
- platelet rich plasma
- sewage sludge