A case report of mesenchymal scapular FGF secreting tumor: Importance of follow up in tumor induced osteomalacia.
FGF
Mesenchymal
Paraneoplastic
Tumor induced osteomalacia
Journal
Radiology case reports
ISSN: 1930-0433
Titre abrégé: Radiol Case Rep
Pays: Netherlands
ID NLM: 101467888
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
20
01
2021
revised:
02
02
2021
accepted:
03
02
2021
entrez:
5
3
2021
pubmed:
6
3
2021
medline:
6
3
2021
Statut:
epublish
Résumé
A 46-year-old Asian male with history of atraumatic fracture of femur (requiring the use of a walker), muscle cramps and loosening teeth presents to Endocrine clinic. He had elevated parathyroid hormone, severely low phosphorus, elevated bone-specific ALP, with normal serum and urine calcium. He was found to have elevated FGF 23 levels, but initial functional and anatomic imaging was negative for any localizing tumor. With persistent follow-up and serial imaging, after 3 years, a 2.2 cm right scapular mass was found on MRI. Since it was also visualized on PET/CT, this was suspected to be the cause of his severe hypophosphatemia. He underwent surgical excision and pathology revealed a phosphaturic mesenchymal tumor after excision. Tumor induced osteomalacia is a rare, acquired paraneoplastic syndrome in which a tumor that secretes FGF23 leads to decreased renal phosphate reabsorption, resulting in hypophosphatemia, and bone demineralization. Diagnosis is challenging as common presenting symptoms are nonspecific, but when followed up closely with proper diagnostic modalities, identification & removal of the culprit lesion is usually curative.
Identifiants
pubmed: 33664928
doi: 10.1016/j.radcr.2021.02.002
pii: S1930-0433(21)00066-2
pmc: PMC7900011
doi:
Types de publication
Case Reports
Langues
eng
Pagination
989-993Commentaires et corrections
Type : ErratumIn
Informations de copyright
Published by Elsevier Inc. on behalf of University of Washington.
Références
Am J Med. 1984 Sep;77(3):501-12
pubmed: 6548080
Hum Mol Genet. 2014 Jan 15;23(2):397-407
pubmed: 24006476
N Engl J Med. 1970 Jul 9;283(2):65-70
pubmed: 4316005
J Clin Endocrinol Metab. 1997 Feb;82(2):674-81
pubmed: 9024275
J Clin Endocrinol Metab. 2001 Aug;86(8):3889-99
pubmed: 11502829
Osteoporos Sarcopenia. 2018 Dec;4(4):119-127
pubmed: 30775554
Indian J Radiol Imaging. 2015 Jan-Mar;25(1):63-6
pubmed: 25709169
J Am Acad Dermatol. 2007 Sep;57(3):509-12
pubmed: 17707153
BMC Musculoskelet Disord. 2017 Sep 21;18(1):403
pubmed: 28934935
Urol Int. 1995;55(1):38-40
pubmed: 7571183
Chin J Cancer. 2011 Nov;30(11):794-804
pubmed: 22035861
South Med J. 2011 May;104(5):348-50
pubmed: 21606715
J Bone Miner Res. 2001 May;16(5):806-13
pubmed: 11341325
J Clin Endocrinol Metab. 2016 Oct;101(10):3575-3581
pubmed: 27533306
Clin Nucl Med. 2008 Nov;33(11):752-6
pubmed: 18936605
Endocr Relat Cancer. 2011 Jun 08;18(3):R53-77
pubmed: 21490240
Am J Surg Pathol. 2004 Jan;28(1):1-30
pubmed: 14707860
Br J Radiol. 2017 Apr;90(1072):20160811
pubmed: 28181822