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Tumor-induced osteomalacia and rickets.
M A Nuovo1, H D Dorfman, C C Sun
1Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 100467-2490.
The American Journal of Surgical Pathology
|July 1, 1989
Summary
Tumor-induced osteomalacia is a rare condition causing bone softening due to a tumor. Surgical removal of the tumor typically resolves the vitamin D-resistant condition.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Tumor-induced osteomalacia is a rare clinicopathological entity.
- Characterized by vitamin D-resistant osteomalacia or rickets associated with a tumor.
Observation:
- 72 cases reported, affecting men and women equally, predominantly adults over 30.
- Symptoms include progressive lower leg and back pain.
- Tumors found in bone (40) and soft tissues (31), often in extremities.
Findings:
- Typical chemical findings: low serum phosphorus, normal serum calcium, elevated alkaline phosphatase.
- Low or undetectable serum 1,25-dihydroxyvitamin D levels.
- Histologically, vascular tumors (hemangiopericytomas) are common; tumors show prominent vascularity, giant, and primitive stromal cells.
Implications:
- Complete tumor removal generally leads to dramatic reversal of osteomalacia symptoms and signs.
- Highlights the critical role of the tumor in causing this metabolic bone disease.
- Further research into tumor-specific mechanisms is warranted.