The case of oncogenic hypophosphatemic osteomalacia
Anna K. Eremkina,
Svetlana S. Mirnaya,
Anna M. Gorbacheva,
Taras S. Panevin,
Iya A. Voronkova,
N. G. Mokrysheva https://doi.org/10.14341/omet12472
Abstract
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.
About the Authors
Anna K. Eremkina
Endocrinology Research Centre
Russian Federation
Russian Federation
PhD
Svetlana S. Mirnaya
Endocrinology Research Centre
Russian Federation
Russian Federation
MD, research associate
Anna M. Gorbacheva
Endocrinology Research Centre
Russian Federation
Russian Federation
MD
Taras S. Panevin
Endocrinology Research Centre; Research Institute of Rheumatogy named after V.A. Nasonova
Russian Federation
Russian Federation
MD
Iya A. Voronkova
Endocrinology Research Centre; Moscows regional research clinical institute n.a. M.F. Vladimirskiy
Russian Federation
Russian Federation
MD, PhD
N. G. Mokrysheva
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
MD, PhD, Professor
Competing Interests:
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Supplementary files
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1. Figure 1. Results of physical examination of patient K. | |
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| Type | Figure 1. A - acne vulgaris on the skin of the back of the patient; B - formations of the mucous membrane of the patient’s tongue (marked by arrows); C - volumetric formation of the medial surface of the right knee region (indicated by a dashed line). | |
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2. Figure 2. Micropreparations of a phosphaturic mesenchymal tumor removed from patient K. | |
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| Type | Figure 2. Histological samples of the patient K.'s phosphaturic mesenchymal tumor. A tumor of spindle-shaped and stellate cells in an unusual basophilic matrix (A, B). A well-developed capillary network and foci of deposition of calcium salts (B), x200 | |
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For citations:
Eremkina A.K., Mirnaya S.S., Gorbacheva A.M., Panevin T.S., Voronkova I.A., Mokrysheva N.G. The case of oncogenic hypophosphatemic osteomalacia. Obesity and metabolism. 2020;17(2):220-227. (In Russ.) https://doi.org/10.14341/omet12472
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