Images in Clinical Rheumatology
Osteomalacia Produced by a Hyperphosphaturic Tumor
Osteomalacia provocada por un tumor hiperfosfatúrico
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Veiga Cabello, José M. Ruiz Giardín" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Miguel" "apellidos" => "Cantalejo Moreira" "email" => array:1 [ 0 => "mcantalejo.hflr@salud.madrid.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Raúl M." "apellidos" => "Veiga Cabello" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "José M." "apellidos" => "Ruiz Giardín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Reumatología, Hospital Universitario de Fuenlabrada, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Osteomalacia provocada por un tumor hiperfosfatúrico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1912 "Ancho" => 2167 "Tamanyo" => 161843 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">CT scan of pelvis showing multiple fractures in different stages of progression at the level of the right pubis and ischium bilaterally.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Oncogenic osteomalacia is caused by the action of fibroblast growth factor 23 (FGF 23) on the renal proximal tubule, causing hyperphosphaturia and, as a consequence, bone hypophosphatemia and metabolic disease.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> FGF 23 usually occurs in tumors of mesothelial origin.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Less than 150 cases are described in the literature.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Case</span><p id="par0010" class="elsevierStylePara elsevierViewall">A 53 year woman, without notable history, came to the emergency room presenting mechanical, intense pelvic pain and inability to stand or walk. Urgent laboratory analysis highlighted an alkaline phosphatase value of 398<span class="elsevierStyleHsp" style=""></span>U/l (30–120), the rest of the blood count and biochemistry values were normal. AN AP radiograph of the pelvis showed osteopenia with no other findings. The patient was admitted and a second set of laboratory tests requested: phosphate 1.2<span class="elsevierStyleHsp" style=""></span>mg/dl (2.5–4.5), alkaline phosphatase 395<span class="elsevierStyleHsp" style=""></span>U/l (30–120), 1.25 vitamin D3 32.7<span class="elsevierStyleHsp" style=""></span>ng/ml (30–40), phosphaturia, 1436.00<span class="elsevierStyleHsp" style=""></span>mg/24<span class="elsevierStyleHsp" style=""></span>h (400–1300). Other values were normal. An isotope bone scan was requested (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), as were a pelvic CT (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) and a pelvic MRI. A subsequent physical examination demonstrated that the patient had hard, painless, 2<span class="elsevierStyleHsp" style=""></span>cm×2<span class="elsevierStyleHsp" style=""></span>cm erythematous and bullous lesions on the sole of her left foot. Suspecting a phosphaturic tumor an octreotide scintigraphy was requested and found normal. We requested an MRI of the foot (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>) and removed the lesion. The pathologic diagnosis was: mixed connective tissue variant mesenchymal tumor. After removal of the tumor, the patient returned to normal blood and urine phosphate values and no new fractures occur.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0015" class="elsevierStylePara elsevierViewall">The first case was described by Mc Cance in 1947<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and the association of the tumor with metabolic disease was made in 1959 by Prader et al.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Less than 150 cases are described in the literature. Most tumors are of mesenchimal origin,<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a> with many cases being small and difficult to locate tumors, a situation that delays diagnosis 2.5 years (2.5 months–19 years) on average from the onset of locomotor symptoms.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Many of these tumors express somatostatin receptors, therefore labeled octreotide scintigraphy may be useful in the diagnosis.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,9</span></a> Removal of the tumor often resolves the metabolic<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> disorder.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical disclosures</span><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Protection of human and animal subjects.</span> The authors declare that the procedures followed were in accordance with the regulations of the responsible Clinical Research Ethics Committee and in accordance with those of the World Medical Association and the Helsinki Declaration.<span class="elsevierStyleVsp" style="height:0.5px"></span></p><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Confidentiality of Data.</span> The authors declare that no patient data appears in this article.<span class="elsevierStyleVsp" style="height:0.5px"></span></p><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Right to privacy and informed consent.</span> The authors must have obtained the informed consent of the patients and /or subjects mentioned in the article. The author for correspondence must be in possession of this document.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Ethical disclosures" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Cantalejo Moreira M, et al. Osteomalacia provocada por un tumor hiperfosfatúrico. Reumatol Clin. 2013;9:250–1.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1208 "Ancho" => 1580 "Tamanyo" => 226051 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Bone scan: multiple bone involvement, with fixed tracer (99mTc-diphosphonates) found in bilateral ribs, a vertebral body, the horizontal branch of the pubis and right inferior pubic ramus.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1912 "Ancho" => 2167 "Tamanyo" => 161843 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">CT scan of pelvis showing multiple fractures in different stages of progression at the level of the right pubis and ischium bilaterally.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1887 "Ancho" => 1500 "Tamanyo" => 233871 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">MRI of left foot: soft tissue solid tumor, poly-lobular, measuring 5.3<span class="elsevierStyleHsp" style=""></span>cm×2.6<span class="elsevierStyleHsp" style=""></span>cm×2<span class="elsevierStyleHsp" style=""></span>cm in a subdermal location, inserted deep into the muscular plane, separated from the bone.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tumor-induced osteomalacia and the regulation of phosphate homeostasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R. Kumar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Bone" "fecha" => "2000" "volumen" => "27" "paginaInicial" => "333" "paginaFinal" => "338" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10962341" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fibroblast growth factor 23: a new clinical market for oncogenic osteomalacia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.E. Nelson" 1 => "R.C. Bligh" 2 => "M. Mirams" 3 => "A. Gill" 4 => "A. Au" 5 => "A. Clarkson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2002-021919" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2003" "volumen" => "88" "paginaInicial" => "4088" "paginaFinal" => "4094" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12970268" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Oncogenic osteomalacia: diagnostic importance of fibroblast growth factor 23 and F-18 fluorodeoxyglucose PET/CT scan for the diagnosis and follow-up in one case" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.L. Dupond" 1 => "H. Mahammedi" 2 => "D. Prie" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.bone.2005.01.001" "Revista" => array:6 [ "tituloSerie" => "Bone" "fecha" => "2005" "volumen" => "36" "paginaInicial" => "375" "paginaFinal" => "378" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15777669" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteomalacia with Looser's nodules due to a raised resistance to vitamin D acquired about the age of 15 years" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.A. Mc Cance" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Q J Med" "fecha" => "1947" "volumen" => "16" "paginaInicial" => "33" "paginaFinal" => "46" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20296654" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infolge, knochen tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "V. Prader" 1 => "R. Illig" 2 => "E. Vehlinger" 3 => "G. Stalder" 4 => "Rachitis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Helv Paediatr Acta" "fecha" => "1959" "volumen" => "14" "paginaInicial" => "554" "paginaFinal" => "565" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14434619" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tumor induced osteomalacia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.M. Jan De Beur" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Primer on the metabolic bone diseases and disorders of mineral metabolism" "paginaInicial" => "345" "paginaFinal" => "350" "edicion" => "6th ed." "serieFecha" => "2006" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tumor-induced osteomalacia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.K. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 14 | 22 |
| 2024 October | 27 | 29 | 56 |
| 2024 September | 47 | 17 | 64 |
| 2024 August | 60 | 28 | 88 |
| 2024 July | 43 | 24 | 67 |
| 2024 June | 53 | 32 | 85 |
| 2024 May | 44 | 40 | 84 |
| 2024 April | 59 | 30 | 89 |
| 2024 March | 46 | 24 | 70 |
| 2024 February | 70 | 21 | 91 |
| 2024 January | 50 | 17 | 67 |
| 2023 December | 37 | 24 | 61 |
| 2023 November | 49 | 21 | 70 |
| 2023 October | 49 | 27 | 76 |
| 2023 September | 70 | 35 | 105 |
| 2023 August | 40 | 19 | 59 |
| 2023 July | 35 | 22 | 57 |
| 2023 June | 41 | 20 | 61 |
| 2023 May | 46 | 23 | 69 |
| 2023 April | 27 | 11 | 38 |
| 2023 March | 47 | 33 | 80 |
| 2023 February | 42 | 24 | 66 |
| 2023 January | 46 | 17 | 63 |
| 2022 December | 69 | 26 | 95 |
| 2022 November | 59 | 28 | 87 |
| 2022 October | 48 | 26 | 74 |
| 2022 September | 34 | 38 | 72 |
| 2022 August | 31 | 49 | 80 |
| 2022 July | 39 | 44 | 83 |
| 2022 June | 37 | 29 | 66 |
| 2022 May | 40 | 32 | 72 |
| 2022 April | 57 | 42 | 99 |
| 2022 March | 59 | 41 | 100 |
| 2022 February | 68 | 37 | 105 |
| 2022 January | 67 | 39 | 106 |
| 2021 December | 27 | 33 | 60 |
| 2021 November | 43 | 44 | 87 |
| 2021 October | 57 | 44 | 101 |
| 2021 September | 32 | 37 | 69 |
| 2021 August | 66 | 46 | 112 |
| 2021 July | 49 | 24 | 73 |
| 2021 June | 32 | 44 | 76 |
| 2021 May | 44 | 26 | 70 |
| 2021 April | 62 | 57 | 119 |
| 2021 March | 51 | 31 | 82 |
| 2021 February | 37 | 23 | 60 |
| 2021 January | 25 | 19 | 44 |
| 2020 December | 19 | 8 | 27 |
| 2020 November | 19 | 15 | 34 |
| 2020 October | 13 | 7 | 20 |
| 2020 September | 26 | 15 | 41 |
| 2020 August | 20 | 15 | 35 |
| 2020 July | 16 | 21 | 37 |
| 2020 June | 19 | 10 | 29 |
| 2020 May | 19 | 16 | 35 |
| 2020 April | 26 | 14 | 40 |
| 2020 March | 15 | 6 | 21 |
| 2020 February | 2 | 0 | 2 |
| 2019 April | 2 | 0 | 2 |
| 2019 January | 1 | 0 | 1 |
| 2018 May | 4 | 3 | 7 |
| 2018 April | 67 | 8 | 75 |
| 2018 March | 68 | 9 | 77 |
| 2018 February | 41 | 10 | 51 |
| 2018 January | 29 | 7 | 36 |
| 2017 December | 48 | 7 | 55 |
| 2017 November | 40 | 5 | 45 |
| 2017 October | 33 | 4 | 37 |
| 2017 September | 38 | 7 | 45 |
| 2017 August | 50 | 8 | 58 |
| 2017 July | 48 | 7 | 55 |
| 2017 June | 42 | 8 | 50 |
| 2017 May | 60 | 10 | 70 |
| 2017 April | 50 | 3 | 53 |
| 2017 March | 58 | 5 | 63 |
| 2017 February | 32 | 8 | 40 |
| 2017 January | 55 | 2 | 57 |
| 2016 December | 81 | 16 | 97 |
| 2016 November | 67 | 5 | 72 |
| 2016 October | 79 | 15 | 94 |
| 2016 September | 120 | 13 | 133 |
| 2016 August | 84 | 11 | 95 |
| 2016 July | 28 | 15 | 43 |
| 2016 June | 1 | 17 | 18 |
| 2016 February | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 1 | 13 | 14 |
| 2015 September | 1 | 0 | 1 |
| 2015 August | 4 | 0 | 4 |
| 2015 July | 54 | 6 | 60 |
| 2015 June | 47 | 13 | 60 |
| 2015 May | 68 | 27 | 95 |
| 2015 April | 63 | 22 | 85 |
| 2015 March | 114 | 16 | 130 |
| 2015 February | 64 | 6 | 70 |
| 2015 January | 53 | 10 | 63 |
| 2014 December | 60 | 15 | 75 |
| 2014 November | 52 | 6 | 58 |
| 2014 October | 59 | 11 | 70 |
| 2014 September | 56 | 17 | 73 |
| 2014 August | 47 | 21 | 68 |
| 2014 July | 62 | 15 | 77 |
| 2014 June | 47 | 10 | 57 |
| 2014 May | 68 | 15 | 83 |
| 2014 April | 46 | 9 | 55 |
| 2014 March | 66 | 12 | 78 |
| 2014 February | 72 | 9 | 81 |
| 2014 January | 45 | 11 | 56 |
| 2013 December | 40 | 7 | 47 |
| 2013 November | 49 | 10 | 59 |
| 2013 October | 46 | 6 | 52 |
| 2013 September | 54 | 9 | 63 |
| 2013 August | 46 | 34 | 80 |
| 2013 July | 11 | 13 | 24 |
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