Presentation
Presentation A middle aged lady presented with progressive generalised bone pain for 6 years and weakness for 2 years. At presentation she required support for walking. [radiopaedia.org]
Oncogenic osteomalacia should be considered in the differential diagnosis for patients with a malignant tumor who present with hypophosphatemia. [pubmed.ncbi.nlm.nih.gov]
Case report A 21-year-old man presented for evaluation of a pathological femur fracture. [touchendocrinology.com]
Both XLH and ADHR typically present in childhood, although ADHR can present with variable or delayed age of onset. [appliedradiology.com]
Results: A 48-year-old, wheelchair-dependent man presented to a tertiary care academic hospital with progressive back pain and diffuse weakness. [journals.aace.com]
Entire Body System
- Pain
Keywords oncogenic osteomalacia; tumour-induced osteomalacia; hypophosphatemia; bone pain; pathological fractures About this article Title Oncogenic osteomalacia should be considered in hypophosphatemia, bone pain and pathological fractures Journal Endokrynologia [journals.viamedica.pl]
The patient had been otherwise healthy until age 18, when he noted onset of lower back pain after soccer practice, which was exacerbated by exercise and improved when being resting. This pain was progressive and he started noticing a loss of height. [touchendocrinology.com]
Patient 1 A 45-year-old male was suffering from diffuse bilateral lower limb pain for the past 8 years and experiencing bilateral lower limb weakness for the past 1 year. He also complained of recent onset anterior chest pain on coughing. [ijaweb.org]
We report the case of a 54-year old man who presented with diffuse bone pain and bilateral hip pain evolving for 3 years. Physical examination revealed a subcutaneous tumor of the left flank. [ajol.info]
She was presented with severe generalized bone and muscle pain and was restricted to bed. She lost 20cm in height over the 8 years since she had first noticed a pain in her thigh. [kjim.org]
- Fatigue
Abstract The clinical manifestation of oncogenic osteomalacia includes bone pain, pathological fractures, general fatigue and muscle weakness. [journals.viamedica.pl]
[…] phosphatonin gene is FGF23 Associated conditions orthopaedic manifestations pathological fractures of long bones and vertebrae Presentation Symptoms generalized bone and muscle pain fractures of long bones, ribs and vertebrae proximal muscle weakness fatigue [orthobullets.com]
Signs and symptoms [ edit ] Adult patients have worsening myalgias, bone pains and fatigue which are followed by recurrent fractures. [en.wikipedia.org]
- Collapse
Most of the vertebral bones were severely demineralized and collapsed, resulting in severe scoliosis and shortening of the distance between the lower anterior costal margin and the iliac crest. [kjim.org]
- Swelling
Specifically, A549 and H460 cells in different groups were seeded into the upper chamber of a 24-well Tran-swell Permeable Support (Costar, USA) at a concentration of 2×105 cells/well. [karger.com]
Respiratoric
- Cough
He also complained of recent onset anterior chest pain on coughing. Misdiagnosed as an autoimmune disorder, he had received treatment in the form of oral corticosteroids for a period of 4 months with no clinical benefit. [ijaweb.org]
Musculoskeletal
- Fracture
Keywords oncogenic osteomalacia; tumour-induced osteomalacia; hypophosphatemia; bone pain; pathological fractures About this article Title Oncogenic osteomalacia should be considered in hypophosphatemia, bone pain and pathological fractures Journal Endokrynologia [journals.viamedica.pl]
While he was walking, he fell and suffered a pathologic right femoral fracture. [touchendocrinology.com]
Teriparatide in cervical fracture consolidation Cordeiro Albino C., Porcelli Savarani C., Aguiar Moreira C. [ccmbm.com]
[…] of long bones and vertebrae Presentation Symptoms generalized bone and muscle pain fractures of long bones, ribs and vertebrae proximal muscle weakness fatigue Imaging Radiographs findings Octrotide scans (radiolabeled somatostatin analog) gallium-68 [orthobullets.com]
Diffuse skeletal uptake often presents as a “superscan” with focal up-take at sites of fractures. [appliedradiology.com]
- Bone Pain
Keywords oncogenic osteomalacia; tumour-induced osteomalacia; hypophosphatemia; bone pain; pathological fractures About this article Title Oncogenic osteomalacia should be considered in hypophosphatemia, bone pain and pathological fractures Journal Endokrynologia [journals.viamedica.pl]
Presentation A middle aged lady presented with progressive generalised bone pain for 6 years and weakness for 2 years. At presentation she required support for walking. [radiopaedia.org]
[…] tissue variant, see Am J Surg Pathol 2004;28:1 ) Symptoms: bone pain, fractures, renal phosphate wasting, hypophosphatemia, decreased 1,25 Vitamin D3 levels, resistance to Vitamin D supplementation Back to top [pathologyoutlines.com]
We report the case of a 54-year old man who presented with diffuse bone pain and bilateral hip pain evolving for 3 years. Physical examination revealed a subcutaneous tumor of the left flank. [ajol.info]
Osteomalacia causes bone pain and can lead to pathological fractures or rickets in young patients where the epiphyses have not matured. Severe hypophosphatemia can cause muscle weakness. [orpha.net]
Neurologic
- Confusion
Conclusion: TIO is frequently confused with normocalcemic hyperparathyroidism and vitamin-D resistant rickets/osteomalacia, which increases patient morbidity. [journals.viamedica.pl]
Workup
Workup included vitamin D deficiency/resistance, renal tubular acidosis and malabsorption all of which were negative. To evaluated for a paraneoplastic cause and blood pool scintigraphy was done. [radiopaedia.org]
When a tumour is surgically unresectable or not localised after an extensive workup, oral combined with phosphate treatment, calcium, and calcitriol is recommended, along with phosphate monitoring, a treatment similar to that used in the genetics forms [touchendocrinology.com]
It is usually very difficult to locate the tumor site, and workup requires numerous imaging procedures and modalities (5). Even with modern techniques of molecular imaging, it is not easy to both locate and identify these tumors. [scielo.br]
Serum
- Hypophosphatemia
Keywords oncogenic osteomalacia; tumour-induced osteomalacia; hypophosphatemia; bone pain; pathological fractures About this article Title Oncogenic osteomalacia should be considered in hypophosphatemia, bone pain and pathological fractures Journal Endokrynologia [journals.viamedica.pl]
Severe hypophosphatemia can cause muscle weakness. Etiology This syndrome is caused by phosphatonin secretion by the causative tumor. [orpha.net]
Oncogenic osteomalacia should be considered in the differential diagnosis for patients with a malignant tumor who present with hypophosphatemia. [pubmed.ncbi.nlm.nih.gov]
Resection of a localized tumor resolves the hypophosphatemia and osteomalacia. [annals.org]
- Hypophosphatemia
Keywords oncogenic osteomalacia; tumour-induced osteomalacia; hypophosphatemia; bone pain; pathological fractures About this article Title Oncogenic osteomalacia should be considered in hypophosphatemia, bone pain and pathological fractures Journal Endokrynologia [journals.viamedica.pl]
Severe hypophosphatemia can cause muscle weakness. Etiology This syndrome is caused by phosphatonin secretion by the causative tumor. [orpha.net]
Oncogenic osteomalacia should be considered in the differential diagnosis for patients with a malignant tumor who present with hypophosphatemia. [pubmed.ncbi.nlm.nih.gov]
Resection of a localized tumor resolves the hypophosphatemia and osteomalacia. [annals.org]
Treatment
Management and treatment Definitive treatment is with surgical resection of the tumor. If the tumor cannot be found or removed, medical treatment involves the supplementation of phosphate and active vitamin D (e.g. alfacalcidol). [orpha.net]
The electrolytic disturbances were exacerbated after the administration of bisphosphonates in the context of her oncological treatment. [eprints.soton.ac.uk]
The treatment of TIO is resection of the tumour and the symptoms and phosphorus levels return to normal. If the tumour is not found, usually we must continue with medical treatment with phosphorus supplementation and vitamin D. [touchendocrinology.com]
If the tumor cannot be located, treatment with calcitriol (1-3 µg/day) and phosphorus (1-4 g/day in divided doses) is instituted. Tumors which secrete somatostatin receptors may respond to treatment with octreotide. [en.wikipedia.org]
Prognosis
Prognosis Excellent recovery after complete tumor excision with complete resolution of symptoms and biochemical abnormalities. Long term monitoring is required as local recurrence and metastases have been reported, even if rarely. [orpha.net]
Overall, the tumour prognosis is good, however, in our patient, due to the diagnosis of sarcoma, close follow-up will be mandatory. [touchendocrinology.com]
The development of cancer involves multiple factors that may affect treatment and prognosis. [karger.com]
This proposed analysis, if validated, should fundamentally transform the diagnosis, prognosis and treatment of malignant disease. [jeccr.biomedcentral.com]
Etiology
Etiology This syndrome is caused by phosphatonin secretion by the causative tumor. [orpha.net]
Even though knowing the underlying etiology would explain his osteomalacia, the patient sought medical help from countless physicians for five consecutive years, and only after adequate treatment a rewarding outcome was achieved. [scielo.br]
Excessive paraneoplastic production of phosphatonin is thought to be involved in the etiology of tumor-induced osteomalacia, whereas impaired degradation and processing of phosphatonin due to endopeptidase mutations (PHEX gene: phosphate-regulating gene [appliedradiology.com]
CAS Google Scholar Malins DC, Polissar NL, Nishikida K, Holmes EH, Gardner HS, Gunselman SJ: The etiology and prediction of breast cancer. [jeccr.biomedcentral.com]
Epidemiology
Introduction Definition paraneoplastic syndrome of renal phosphate wasting caused by bone tumor or soft tissue tumor Epidemiology demographics age bracket age of onset is late childhood to early adulthood Pathophysiology the tumor secretes a humoral factor [orthobullets.com]
Summary Epidemiology The prevalence of the disease is not known. Since the association between phosphate reabsorption and tumor was first made, approximately 400 cases of oncogenic osteomalacia have been reported in the literature. [orpha.net]
Pathophysiology
Pathophysiology It has been clear for a long time that a humoral substance caused the osteomalacia, because the bone disease resolves when the tumors are resected. [courses.washington.edu]
Objective: To present a rare case of oncogenic osteomalacia, describe the breadth of potential clinical symptoms, and review the underlying pathophysiology of this disorder. [journals.aace.com]
Introduction Definition paraneoplastic syndrome of renal phosphate wasting caused by bone tumor or soft tissue tumor Epidemiology demographics age bracket age of onset is late childhood to early adulthood Pathophysiology the tumor secretes a humoral factor [orthobullets.com]
Pathophysiology of X-linked hypophosphatemia, tumor-induced osteomalacia, and autosomal dominant hypophosphatemia: A perPHEXing problem. J Clin Endocrinol Metab 2001;86:494-6. 10. Strewler GJ. [ijri.org]
Pathophysiologically, TIO is caused by tumours that secrete fibroblast growth factor 23 (FGF-23), a phosphaturic circulating hormone. [touchendocrinology.com]
Prevention
[…] of Osteomalacia Yes, it may be possible to prevent Osteomalacia. [tabletwise.net]
In the PACU, adequate analgesia was provided, prevention of deep venous thrombosis ensured and close monitoring for hypo- and hyper-calcaemia was done. [ijaweb.org]