First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
Intern Med. 2020 Oct 15;59(20):2523-2527. doi: 10.2169/internalmedicine.4412-19. Epub 2020 Jul 7.
A 53-year-old woman presented with bone pain and was diagnosed with osteomalacia because of hypophosphatemia, hyperphosphatasemia, bone pain, and radiographic findings. Because her intact-fibroblast growth factor 23 (FGF23) levels were high and contrast-enhanced computed tomography revealed a mass in the anterior ethmoid sinus, FGF23-related osteomalacia was diagnosed. The tumor was resected, but she developed hypercalcemia and elevated blood parathyroid hormone (PTH) levels. Primary hyperparathyroidism (PHPT) was diagnosed, and surgical resection was performed. To our knowledge, this is the first case of a FGF23-producing tumor complicated by PHPT. Because PHPT manifested after resecting the FGF23-producing tumor, FGF23 is thus considered to suppress PTH secretion in humans.
一位 53 岁女性因骨痛就诊，检查发现低磷血症、高磷酸血症、骨痛和影像学表现，被诊断为佝偻病。因为她的完整成纤维细胞生长因子 23（FGF23）水平很高，且增强 CT 显示额窦前有肿块，所以诊断为 FGF23 相关佝偻病。肿瘤被切除，但她出现高钙血症和甲状旁腺激素（PTH）水平升高。诊断为原发性甲状旁腺功能亢进症（PHPT），并进行了手术切除。据我们所知，这是首例 FGF23 分泌性肿瘤并发 PHPT 的病例。由于 PHPT 在切除 FGF23 分泌性肿瘤后出现，因此认为 FGF23 可抑制人类 PTH 的分泌。
