Crossen Stephanie S, Zambrano Eduardo, Newman Beverley, Bernstein Jonathan A, Messner Anna H, Bachrach Laura K, Twist Clare J
Divisions of *Pediatric Endocrinology and Diabetes §Medical Genetics ¶Pediatric Hematology and Oncology Departments of †Pathology ‡Radiology ∥Otolaryngology, Stanford University School of Medicine, Stanford, CA.
J Pediatr Hematol Oncol. 2017 Jan;39(1):e21-e24. doi: 10.1097/MPH.0000000000000686.
Tumor-induced osteomalacia (TIO) is a rare cause of hypophosphatemia involving overproduction of fibroblast growth factor 23. TIO has been described largely in adults with small mesenchymal tumors. We report a case of TIO in a child who presented with knee pain and radiographic findings concerning for rickets, and was found to have maxillomandibular giant cell lesions. The patient was treated with oral phosphorus and calcitriol, surgical debulking, and intralesional corticosteroids, which resulted in tumor regression and normalization of serum fibroblast growth factor 23 and phosphorus. This case illustrates the occurrence of this rare paraneoplastic syndrome in children and adds to our knowledge about clinical manifestations and pathologic findings associated with pediatric TIO.
肿瘤诱导的骨软化症（TIO）是低磷血症的一种罕见病因，涉及成纤维细胞生长因子23的过度产生。TIO主要在患有小间充质肿瘤的成人中被描述。我们报告了一例TIO患儿，该患儿表现为膝关节疼痛及与佝偻病相关的影像学表现，并被发现患有颌骨巨细胞病变。该患者接受了口服磷和骨化三醇、手术减瘤及病灶内注射皮质类固醇治疗，结果肿瘤消退，血清成纤维细胞生长因子23和磷恢复正常。本病例说明了这种罕见的副肿瘤综合征在儿童中的发生情况，并增加了我们对与儿童TIO相关的临床表现和病理发现的认识。
