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Oncogenous osteomalacia: a case study.

D W Nitzan1, A T Horowitz, D Darmon

  • 1Department of Oral Surgery, Hadassah University Hospital, Jerusalem, Israel.

Bone and Mineral
|May 1, 1989
PubMed
Summary
This summary is machine-generated.

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This study reports a rare case of oncogenous osteomalacia caused by a maxillary fibrosarcoma. Tumor removal corrected metabolic abnormalities, confirming its role in causing this rare bone disease.

Area of Science:

  • Oncology
  • Endocrinology
  • Nephrology

Background:

  • Oncogenous osteomalacia is a rare paraneoplastic syndrome characterized by renal phosphate wasting and bone mineralization defects.
  • Fibrosarcomas, particularly those in the maxillofacial region, are rarely associated with this condition.

Observation:

  • A 19-year clinical course of oncogenous osteomalacia was observed in a patient with a maxillary fibrosarcoma.
  • Metabolic studies revealed persistent negative calcium and phosphorus balance and low serum 1,25-dihydroxyvitamin D levels.

Findings:

  • Surgical resection of the fibrosarcoma led to the correction of hypophosphatemia, phosphaturia, and vitamin D deficiency.
  • In vitro studies showed tumor supernatant did not directly impact renal tubular phosphorus transport.

Related Experiment Videos

  • In vivo studies using athymic nude mice demonstrated that tumor xenografts induced hypophosphatemia and phosphaturia, confirming a humoral factor.

    • Implications:

    • This case highlights the importance of considering rare paraneoplastic syndromes in the differential diagnosis of metabolic bone disease.
    • The findings confirm the endocrine nature of the factor produced by the fibrosarcoma responsible for oncogenous osteomalacia.
    • Successful treatment involved surgical management of the primary tumor, underscoring the need for prompt diagnosis and intervention.