Tumor-induced osteomalacia due to a recurrent mesenchymal tumor overexpressing several growth factor receptors

Endocrinology, Diabetes & Metabolism Case Reports

article

Maria P Yavropoulou¹  Nikolina Gerothanasi¹  Athanasios Frydas¹  Evangelia Triantafyllou¹  Chris Poulios²  Prodromos Hytiroglou²  Panagiotis Apostolou³  Ioannis Papasotiriou³  Symeon Tournis⁴  Isaak Kesisoglou⁵  John G Yovos¹ 

[1] Division of Clinical and Molecular Endocrinology, 1st Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki;Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki;Research Genetic Cancer Centre Ltd ,(RGCC Ltd);Laboratory of Research of Musculoskeletal System ‘Th. Garofalidis’, Medical School, KAT Hospital, University of Athens;3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki

关键词: Adult;    Male;    White;    Greece;    Bone;    Parathyroid;    Tumours and neoplasia;    Calcitriol;    PTH;    Osteomalacia;    Paraneoplastic syndromes;    Parathyroid adenoma;    Tumour-induced osteomalacia;    Myasthaenia;    Myalgia;    Cramps;    Hypophosphataemia;    Phosphate (urine);    PTH;    Alkaline phosphatase;    Calcium (serum);    Calcium (urine);    Vitamin D;    MRI;    FGF23;    Genetic analysis;    Octreotide scan;    Parathyroid scintigraphy;    Amputation;    Calcitriol;    Calcimimetics;    Cinacalcet;    Phosphate supplements;    Insight into disease pathogenesis or mechanism of therapy;    July;    2015;   

DOI  :  10.1530/EDM-15-0025

学科分类：血液学

来源: Bioscientifica Ltd.

【 摘 要 】

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused primarily by benign mesenchymal tumors.These tumors typically follow a benign clinical course and local recurrence occurs in !5% of cases. We investigated a49-year-old man with a recurrent mesenchymal phosphaturic tumor showing no signs of malignancy. The patient sufferedfrom chronic muscle weakness, myalgia and cramps. His medical record included the diagnosis of oncogenic osteomalacia,for which he was submitted to tumor resection in the left leg three times before. Laboratory examination showedhypophosphatemia, hyperphosphaturia and an elevated serum FGF23 level. A radical surgical approach (amputation) wasadvised, however, complete biochemical and clinical remission was not reached. Molecular analysis of the tumor cellsdemonstrated overexpression of growth factor receptors implicated in tumor angiogenesis and metastatic potential(platelet derived growth factor type A (PDGFRA), PDGFRB and vascular endothelial growth factor receptor) togetherwith increased expression of FGF23, x-linked-phosphate-regulating endopeptidase and KLOTHO. TIO is usually associatedwith benign phosphauturic tumors and, when identified, resection of the tumor leads to complete remission in the majorityof cases. The underlying pathophysiology of recurrences in these tumors is not known. This is the first report showingincreased expression of growth factor receptors in a locally aggressive but histopathologically benign phosphaturicmesenchymal tumor.

【 授权许可】

CC BY-NC-ND