Department of Endocrinology, Chinese PLA General Hospital, Fuxing Road 28, Beijing 100853, China.
Rheumatol Int. 2012 Aug;32(8):2573-6. doi: 10.1007/s00296-011-2018-4. Epub 2011 Jul 26.
Tumor-induced osteomalacia (TIO) is an extremely rare metabolic bone disease and the occult offending tumor arising in facies cranii is even more uncommon. In this report, we described 2 middle-aged females with TIO caused by the tumor in facies cranii, which had ever been misdiagnosed as rheumatoid arthritis. Case 1 was present with diffuse bone pain and muscle weakness for 4 years, as well as esotropia in the right eye for 1 month. Case 2 was present with progressive bone pain in low back and hip for 2 years. Biochemical studies both showed persistent hypophosphatemia and urinary over wasting phosphate. Radiological examinations revealed the infiltrative mass in right apex partis petrosae ossis temporalis in case 1, and the soft mass in left nasal cavity and ethmoid sinuses in case 2, respectively. The offending tumors were resected completely in case 2, however, incompletely in case 1. Pathology examination revealed mixed connective tissue variant phosphaturic mesenchymal tumors. In conclusion, TIO should be presumed in patients presenting with unexplained persistent hypophosphatemia osteomalacia, also a thorough detection for tumor in facies cranii should be performed.
肿瘤性骨软化症（TIO）是一种极为罕见的代谢性骨病，而发生在颅面部的隐匿性致病肿瘤则更为罕见。本报告描述了 2 例由颅面部肿瘤引起的 TIO 中年女性患者，她们曾被误诊为类风湿关节炎。病例 1 表现为弥漫性骨痛和肌无力 4 年，右眼内斜视 1 个月。病例 2 表现为进行性腰背痛和髋部骨痛 2 年。生化研究均显示持续性低磷血症和尿磷过度排泄。影像学检查分别显示病例 1 右侧颞骨岩部尖端浸润性肿块，病例 2 左侧鼻腔和筛窦软组织肿块。病例 2 中致病肿瘤完全切除，但病例 1 中则不完全切除。病理检查显示混合结缔组织变异型成磷酸盐尿性间叶性肿瘤。总之，对于不明原因的持续性低磷血症性骨软化症患者应考虑 TIO，同时应进行颅面部肿瘤的彻底检查。
