Dataset Information

A diagnostic challenge of mysterious bone pain caused by tumor-induced osteomalacia with multiple tumors: a case report.

ABSTRACT:

Background

Tumor-induced osteomalacia (TIO) is a rare, tumor-induced, metabolic bone disorder, the exact incidence of which is unknown. The most common cause of TIO is hypersecretion of tumor-derived fibroblast growth factor 23 (FGF23). Surgical resection can cure TIO in most cases, while for patients with TIO who are ineligible for surgery, biologic antibodies targeting FGF23 can be used as treatment. However, the diagnosis of TIO is more difficult than its treatment as the initial presentation can be misleading or nonspecific; thus, diagnosing TIO remains a clinical challenge.

Case description

Herein, we present a case of TIO originating from the nasal cavity neoplasm in which the patient also had a rare, thymic-derived, tumorous lesion. A diagnosis of osteoporosis was subsequently made, and a disorder of phosphorus metabolism was discovered. After determining that the patient was exhibiting signs of TIO, we used gallium-68 dotatate positron emission tomography/computed tomography (⁶⁸Ga-DOTATATE PET/CT) to locate the tumor position.

Conclusions

This case report emphasizes the importance of electrolyte testing, which is potentially helpful for quickly identifying the presence of disorders of phosphorus metabolism in suspected patients. Subsequently, appropriate imaging techniques (e.g., ⁶⁸Ga-DOTATATE PET/CT) should be used to identify potential TIO lesions. Most patients with TIO can be treated successfully following diagnosis.

Keywords

Tumor-induced osteomalacia (TIO); gallium-68 dotatate positron emission tomography/computed tomography (⁶⁸Ga-DOTATATE PET/CT); phosphaturic mesenchymal tumor (PMTs); weakness; case report.

SUBMITTER: Han L

PROVIDER: S-EPMC10007871 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

A diagnostic challenge of mysterious bone pain caused by tumor-induced osteomalacia with multiple tumors: a case report.

Han Liang L Wang Yu Y Huang Yao Y Yan Jiahui J Li Tingting T Ba Xin X Lin Weiji W Huang Ying Y Chen Zhe Z Tu Shenghao S Qin Kai K

Translational cancer research 20230203 2

<h4>Background</h4>Tumor-induced osteomalacia (TIO) is a rare, tumor-induced, metabolic bone disorder, the exact incidence of which is unknown. The most common cause of TIO is hypersecretion of tumor-derived fibroblast growth factor 23 (FGF23). Surgical resection can cure TIO in most cases, while for patients with TIO who are ineligible for surgery, biologic antibodies targeting FGF23 can be used as treatment. However, the diagnosis of TIO is more difficult than its treatment as the initial pres ...[more]

PMID: 36915584

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Project description:BackgroundProgressive bone pain and fracture and abnormal positron emission tomography combined with a computed tomography are main reasons for the oncologists suspecting bone tumor. During the patient's medical treatment, the oncologists' unfamiliarity with adverse reactions to anti-HBV drugs were main reason for the long-term exposure to the drug and the adverse reaction (ADR) experienced by the patient.Case presentationA 63-year-old Chinese man had a 27-month history of progressive generalized bone pain combined with spontaneous fractures. Positron emission tomography combined with a computed tomography, revealed an abnormal increase in ribose metabolism and low positron serum inorganic phosphorus concentration (0.7; 0.78-1.65 mmol/L). Serum creatinine level was 252 μmol/L (53-97) μmol/L, and glomerular filtration rate was 22.79 mL/min/1.73 m2. The patient was referred to a multidisciplinary clinic to clarify the diagnosis of myeloma or bone tumor for further treatment in 2017. His medical history revealed that he had a 30-year history of chronic hepatitis B infection. He had received lamivudine at a daily dose of 100 mg for 19 years (1990 to 2009), which had been changed to adefovir (10 mg/day) owing to lamivudine resistance in 2009. Based on the changes in the patient's laboratory markers and the results of emission computed tomography and other radiographic findings, adefovir-induced hypophosphatemic osteomalacia due to acquired renal Fanconi syndrome was suspected by the clinical pharmacist. Considerable clinical improvement was observed after adefovir discontinuation and the administration of entecavir (1.0 mg, every other day).ConclusionFanconi syndrome with osteomalacia can develop in patients with chronic hepatitis B infection being treated with adefovir at a conventional low dosage of 10 mg/day. This case highlights the importance of ADR as a differential diagnosis and the need of pharmacists with drug safety expertise expert in the patient management.

Dataset Information

A diagnostic challenge of mysterious bone pain caused by tumor-induced osteomalacia with multiple tumors: a case report.

Background

Case description

Conclusions

Keywords

Publications

A diagnostic challenge of mysterious bone pain caused by tumor-induced osteomalacia with multiple tumors: a case report.

Similar Datasets

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