Department of Otolaryngology, Head and Neck Surgery, Kanto Medical Center NTT EC, Tokyo, Japan.
Head Neck. 2011 Jul;33(7):1072-5. doi: 10.1002/hed.21355. Epub 2010 Feb 9.
Tumor-induced osteomalacia (TIO) is a rare clinical entity in which secondary osteomalacia is induced by tumor-related products. Fibroblast growth factor 23 (FGF-23) mRNA is overexpressed in the tumor tissue, leading to impaired reabsorption of phosphorus in the renal tubules and hypophosphatemia. Curative treatment is considered to be total resection of the tumor.
A 53-year-old woman had experienced systemic bone pain and muscle weakness for several years. She had refractory hypophosphatemia and marked elevation of serum FGF-23 level. Whole body imaging eventually revealed a hypervascular mass in the right temporal bone, leading to a diagnosis of TIO. She underwent skull-base surgery after embolization of the tumor. After the en bloc resection, FGF-23 became undetectable, phosphate reabsorption normalized, and all symptoms resolved.
We discuss the clinical features and treatment options for this rare disease.
肿瘤相关性骨软化症（TIO）是一种罕见的临床疾病，其特征是肿瘤相关产物导致继发性骨软化症。肿瘤组织中纤维母细胞生长因子 23（FGF-23）mRNA 过度表达，导致肾小管磷重吸收受损和低磷血症。有效的治疗方法被认为是肿瘤的完全切除术。
一名 53 岁女性数年来一直有全身骨痛和肌肉无力的症状。她患有难治性低磷血症和明显的血清 FGF-23 水平升高。全身成像最终显示右颞骨有一个富血管性肿块，诊断为 TIO。在肿瘤栓塞后，她接受了颅底手术。肿瘤整块切除后，FGF-23 检测不到，磷酸盐重吸收恢复正常，所有症状均得到缓解。
我们讨论了这种罕见疾病的临床特征和治疗选择。
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