Clin Nephrol. 2021 Feb;95(2):99-103. doi: 10.5414/CN110139.
Tumor-induced osteomalacia (TIO) can cause severe, persistent hypo-phosphatemia due to high fibroblast growth factor-23 (FGF-23) levels, which lead to uri-nary phosphate wasting. TIO is frequently encountered in association with mesenchy-mal tumors and responds well to resection of the primary malignancy. Rarely, TIO may be seen as a paraneoplastic phenomenon with solid organ malignancies where correction of biochemical abnormalities requires ongoing phosphorus replacement. We report a case of TIO in a patient with metastatic breast cancer complicated by increased parathyroid hormone release secondary to denosumab-induced hypocalcemia. The patient required intensive intravenous and oral phosphate supplementation in addition to vitamin D repletion. A high index of clinical suspicion can yield the correct diagnosis where TIO arises in the setting of a solid organ tumor and help the clinician appropriately manage these challenging cases.
肿瘤相关性骨软化症（TIO）可因成纤维细胞生长因子 23（FGF-23）水平升高导致严重、持续的低磷血症，从而引起尿磷丢失。TIO 常与间叶性肿瘤相关，并对原发性恶性肿瘤切除有良好反应。罕见情况下，TIO 可能作为实体器官恶性肿瘤的副瘤现象出现，此时纠正生化异常需要持续补充磷。我们报告了一例转移性乳腺癌患者发生 TIO 的病例，该患者继发于地舒单抗诱导的低钙血症而甲状旁腺激素释放增加。该患者除了补充维生素 D 外，还需要进行强化静脉和口服磷补充。在实体器官肿瘤中出现 TIO 时，临床医生若能保持较高的警惕性，就有可能做出正确的诊断，并帮助适当管理这些具有挑战性的病例。
