Zhuo Cai,Qiang Meng,Hanfeng Guan,Qing Yang,Caihong Yang,Jun Xiao. Tumor-induced osteomalacia originating from bones: a report of two cases and literature review. Oncol Transl Med, 2016, 2: 69-74.
Tumor-induced osteomalacia originating from bones: a report of two cases and literature review
Received:January 25, 2016  Revised:March 19, 2016
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KeyWord:tumor-induced osteomalacia (TIO); hypophosphatemia; fibroblast growth factor 23 (FGF-23); osteoporosis
Author NameAffiliationE-mail
Zhuo Cai Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. drcaizhuo@hotmail.com 
Qiang Meng Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. mengqiang0830@163.com 
Hanfeng Guan Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. drcaizhuo@hotmail.com 
Qing Yang Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. drcaizhuo@hotmail.com 
Caihong Yang Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. yangcaihong@yahoo.com 
Jun Xiao Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. xiaojun301@sina.com 
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Abstract:
      Tumor-induced osteomalacia (TIO) is caused by a small mesenchymal tumor and characterized by hypophosphatemia, phosphaturia, low levels of 1,25(OH)2 vitamin D, and elevated levels of alkaline phosphatase and fibroblast growth factor 23 (FGF-23). The typical symptoms include bone pain, pseudofracture, osteoporosis, and muscle weakness. These symptoms are due to the overproduction of FGF-23 as a phosphaturic agent. Diagnosis of this disease is challenging because of the small lesion size and chronic symptoms. The cases described in this report were two patients with bone pain, severe muscle weakness, and difficulty performing activities, who were found to have TIO. The tumors were found through various imaging modalities, including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). The tumors responsible for the symptoms were localized on their femurs and resection resulted in normalization of their blood chemistries and complaints.
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