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Tumor-induced osteomalacia combined with increased bone resorption postoperatively: A case report
Lingfeng Shi1, Mengjia Tang, Shanshan Duan
1Endocrinology Department, First Affiliated Hospital of Third Military Medical University (Army Medical University), Chongqing, China.
Medicine
|July 7, 2023
Summary
This study details a rare case of tumor-induced osteomalacia (TIO) in a female patient. Post-surgery, she experienced increased bone pain and spasms, potentially due to active bone remodeling.
Area of Science:
- Endocrinology
- Oncology
- Orthopedics
Background:
- Tumor-induced osteomalacia (TIO) is a rare condition characterized by impaired phosphate reabsorption, leading to bone pain, fractures, and muscle weakness.
- Surgical tumor resection is the primary treatment, but post-operative complications remain poorly understood.
Observation:
- A female patient presented with severe bone pain, muscle spasms, osteoporosis, and multiple fractures.
- Elevated serum fibroblast growth factor 23 (FGF23) and hypophosphatemia confirmed TIO diagnosis.
- PET/CT imaging localized a tumor in the left foot, which was surgically removed.
Findings:
- Post-surgery, serum FGF23 normalized, but markers of bone turnover (procollagen type I and β-CrossLaps) initially increased significantly.
- Within a month, bone turnover markers decreased, and biochemical parameters normalized.
Implications:
- The patient's post-operative bone pain and spasms may be attributed to rapid, active bone remodeling following tumor removal.
- Further research is needed to elucidate the precise mechanisms of this abnormal bone metabolism in TIO patients.
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