Arita Sayaka, Nsihino Tomofumi, Mitani Yuki, Sakashita Kotaro, Totsuka Sho, Watanabe Ryunosuke, Mishima Hajime, Kawai Hitomi, Matsubara Daisuke, Oda Yoshionao, Yamazaki Masashi
College of Medicine, School of Medicine and Health Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
J Surg Case Rep. 2022 Oct 19;2022(10):rjac478. doi: 10.1093/jscr/rjac478. eCollection 2022 Oct.
Tumor-induced osteomalacia (TIO) is a rare tumor-associated syndrome in which osteomalacia is induced by a tumor. A 67-year-old male patient presented for the first time with low back pain, weakness of the lower extremities and difficulty in walking. Six years earlier, he had nonspecific symptoms such as low back pain, and blood tests showed high alkaline phosphatase and low phosphorus. In addition, fibroblast growth factor 23 (FGF23) was abnormally high at 454 pg/mL. A diagnosis of FGF23-related hypophosphatemic osteomalacia was made. Somatostatin receptor scintigraphy, venous sampling and MRI were performed to localize and diagnose TIO. The tumor was found to be confined to the right femoral head and hemiarthroplasty was performed. Pathological examination revealed a phosphaturic mesenchymal tumor. Postoperatively, symptoms and blood test data improved. Although resection of the lesion and osteochondral transplantation or total hip arthroplasty were considered, hemiarthroplasty was chosen over concerns about treatment failure due to seeding.
肿瘤诱导的骨软化症（TIO）是一种罕见的肿瘤相关综合征，其中骨软化症由肿瘤诱发。一名67岁男性患者首次出现腰痛、下肢无力和行走困难。六年前，他有腰痛等非特异性症状，血液检查显示碱性磷酸酶升高和磷降低。此外，成纤维细胞生长因子23（FGF23）异常高，为454 pg/mL。诊断为FGF23相关的低磷性骨软化症。进行了生长抑素受体闪烁显像、静脉采血和MRI以定位和诊断TIO。发现肿瘤局限于右股骨头，遂行半髋关节置换术。病理检查显示为排磷间叶肿瘤。术后，症状和血液检查数据有所改善。尽管考虑过切除病变并进行骨软骨移植或全髋关节置换术，但由于担心种植导致治疗失败，最终选择了半髋关节置换术。
