ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet12472ometendo-12472Research ArticleСлучай из практикиCase ReportСлучай гипофосфатемической остеомаляции опухолевого генезаThe case of oncogenic hypophosphatemic osteomalaciahttps://orcid.org/0000-0001-6667-062XЕремкинаАнна КонстантиновнаEremkinaAnna K.

к.м.н., и.о. зав. отделением патологии околощитовидных желез

PhD

a.lipatenkova@gmail.comhttps://orcid.org/0000-0002-1341-0397МирнаяСветлана СергеевнаMirnayaSvetlana S.

н.с.

MD, research associate

svetlanamirnaya@yahoo.comhttps://orcid.org/0000-0003-2669-9457ГорбачеваАнна МаксимовнаGorbachevaAnna M.

MD

ann.gorbachewa@yandex.ruhttps://orcid.org/0000-0002-5290-156XПаневинТарас СергеевичPanevinTaras S.

MD

tarasel@list.ruhttps://orcid.org/0000-0001-6687-3240ВоронковаИя АлександровнаVoronkovaIya A.

к.м.н.

MD, PhD

iya-v@yandex.ruhttps://orcid.org/0000-0002-9717-9742МокрышеваНаталья ГеоргиевнаMokryshevaN. G.

д.м.н., профессор, член-корр. РАН

MD, PhD, Professor

nm70@mail.ruНаучный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian FederationНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian FederationНациональный медицинский исследовательский центр эндокринологии; Научно-исследовательский институт ревматологии имени В.А. НасоновойРоссияEndocrinology Research Centre; Research Institute of Rheumatogy named after V.A. NasonovaRussian FederationНациональный медицинский исследовательский центр эндокринологии; Московский областной научно-исследовательский клинический институт им. М. Ф. ВладимирскогоРоссияEndocrinology Research Centre; Moscows regional research clinical institute n.a. M.F. VladimirskiyRussian Federation202021092020172220227Copyright © Еремкина А.К., Мирная С.С., Горбачева А.М., Паневин Т.С., Воронкова И.А., Мокрышева Н.Г., 20202020Еремкина А.К., Мирная С.С., Горбачева А.М., Паневин Т.С., Воронкова И.А., Мокрышева Н.Г.Eremkina A.K., Mirnaya S.S., Gorbacheva A.M., Panevin T.S., Voronkova I.A., Mokrysheva N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/12472

Остеомаляция – системное заболевание скелета из группы метаболических остеопатий, характеризующееся избыточным накоплением неминерализованного остеоида и несоответствием между протекающим с нормальной скоростью образованием белкового матрикса и его минерализацией. К одной из самых редких форм заболевания относится остеомаляция опухолевого генеза, чаще всего обусловленная фосфатурическими мезенхимальными опухолями (ФМО). Обычно это доброкачественные опухоли небольших размеров, поражающие мягкие ткани и кости любой локализации. В большинстве случаев непосредственной ФМО-опосредованной причиной остеомаляции становится гиперпродукция опухолью фактора роста фибробластов 23, фосфатурического гормона, реализующего свой эффект за счет воздействия на эпителий проксимальных отделов извитых канальцев почек. Симптомы заболевания неспецифичны, средний срок от появления симптомов до постановки диагноза в этой группе больных достигает 3 лет, а до хирургического лечения, как правило, проходит не менее 5 лет. Топическая диагностика имеет решающее значение, так как в подавляющем большинстве случаев удаление опухоли позволяет достичь ремиссии заболевания. Мы представляем описание клинического случая остеомаляции опухолевого генеза вследствие ФМО, потребовавшей поэтапной дифференциальной диагностики с другими редкими заболеваниями.

Osteomalacia is a systemic bone disease, characterized by an excessive accumulation of non-mineralized osteoid and an imbalance in the organic matrix formation and mineralization. A rare cause of disease is tumor-induced osteomalacia, most often due to phosphaturic mesenchymal tumors (PMT). Usually there are benign small tumors, affecting the soft tissues and bones of any location. The basic pathogenesis of underlying oncogenic osteomalacia is a decreased renal tubular reabsorption of phosphate consequent to hyperproduction of fibroblast growth factor 23 in PMT. Clinical features are nonspecific, the average period from the symptoms onset to diagnosis reaches 3 years and at least 5 years before surgical treatment. Finding the tumour is crucial, as complete removal is curative. We present a clinical case of tumor-induced osteomalacia due to PMT required the complex differential diagnosis with other rare diseases.

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The authors declare that there are no conflicts of interest present.