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The external iliac artery transitions out of the body cavity, entering the femoral region of the lower leg, and is renamed the femoral artery at the point where it traverses the body wall. This artery is responsible for the distribution of blood to the thigh's deep muscles and the skin's ventral and lateral regions, achieved through several minor branches and the lateral deep femoral artery, which also spawns a lateral circumflex artery. The knee area receives blood from the genicular...
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Proband and the Brother.

The Journal of the Association of Physicians of Indiaยท2023
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Lower Limb Biomechanical Analysis of Healthy Participants
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The Right Leg that Troubled the Left Leg.

Santosh B1, Anand V1

  • 1Bangalore Baptist Hospital, Bengaluru, Karnataka, India.

The Journal of the Association of Physicians of India
|April 28, 2023
PubMed
Summary

Oncogenic osteomalacia, a rare condition causing defective bone mineralization due to FGF-23, was successfully treated by surgically removing a mesenchymal tumor. This case highlights the importance of prompt diagnosis and treatment for improved patient outcomes.

Area of Science:

  • Endocrinology
  • Oncology
  • Bone Metabolism

Background:

  • Oncogenic osteomalacia (TIO) is a rare paraneoplastic syndrome.
  • It involves defective bone mineralization caused by Fibroblast Growth Factor-23 (FGF-23).
  • FGF-23 is released from small mesenchymal tumors.

Observation:

  • A 31-year-old female presented with leg pain and difficulty walking.
  • Initial workup revealed elevated alkaline phosphatase, pseudo fractures, and isolated hypophosphatemia.
  • Further investigations showed low Tmp-GFR and high FGF23 levels.

Findings:

  • A whole-body PET scan identified a mesenchymal tumor in the right lower limb.
  • Surgical removal of the tumor led to symptom resolution.
  • This confirmed the diagnosis of oncogenic osteomalacia.

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Implications:

  • Oncogenic osteomalacia is a rare cause of renal phosphate wasting and severe hypophosphatemia.
  • Surgical tumor removal offers an excellent prognosis with dramatic improvement.
  • Early diagnosis through high suspicion and prompt investigation improves patient outcomes.