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Oncogenic osteomalacia.

J J Jacob1, P Finny, Meera Thomas

  • 1Department of Endocrinology, Christian Medical College, Vellore, India.

The Journal of the Association of Physicians of India
|June 30, 2007
PubMed
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A rare phosphaturic mesenchymal tumor caused osteomalacia in a 59-year-old man, leading to severe back pain. Surgical removal of the tumor resulted in complete symptom resolution, highlighting the importance of identifying and excising these rare bone tumors.

Area of Science:

  • Oncology
  • Endocrinology
  • Orthopedics

Background:

  • Osteomalacia, a bone disorder characterized by impaired bone mineralization, can present with significant musculoskeletal pain.
  • Rare mesenchymal tumors can secrete fibroblast growth factor 23 (FGF23), leading to oncogenic osteomalacia.
  • This case highlights a rare cause of secondary osteomalacia.

Observation:

  • A 59-year-old gentleman experienced progressive low back pain and difficulty with squatting for two years.
  • Biochemical tests confirmed osteomalacia.
  • A focal hot spot on blood pool scanning near the left index finger's metacarpophalangeal joint indicated a lesion.

Findings:

  • Biopsy of the excised lesion confirmed a phosphaturic mesenchymal tumor.
  • The tumor was identified as the cause of the patient's oncogenic osteomalacia.

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  • Surgical excision of the tumor was curative.

    • Implications:

    • Early diagnosis and surgical management of phosphaturic mesenchymal tumors are crucial for resolving oncogenic osteomalacia.
    • This case underscores the importance of considering rare tumor types in the differential diagnosis of unexplained osteomalacia.
    • Complete resolution of symptoms following tumor excision demonstrates the efficacy of surgical intervention.