Tumor-induced osteomalacia caused by a massive phosphaturic mesenchymal tumor of the acetabulum: A case report

Kimitaka Nakamura, Masanobu Ohishi, Tomoya Matsunobu, Yasuharu Nakashima, Akio Sakamoto, Akira Maekawa, Yoshinao Oda, Yukihide Iwamoto

Research output: Contribution to journalArticle

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Abstract

We report a case of tumor-induced osteomalacia (TIO) caused by a massive phosphaturic mesenchymal tumor (PMT) of the acetabulum. A 68-year-old woman presented with progressive bone pain of the rib cage, and polyarthralgia and back pain for 3 years. She was diagnosed with hypophosphatemic osteomalacia because laboratory testing was remarkable for low serum phosphorus and a low level of 1,25(OH)2 vitamin D. Three years later, her hip radiograph revealed an osteolytic lesion of the acetabulum. Magnetic resonance imaging of the acetabulum showed a massive lesion. Laboratory data showed hypophosphatemia and an elevated serum level of fibroblast growth factor 23 (FGF-23). Samples obtained with open biopsy showed a low-grade spindle cell neoplasm with FGF-23 positivity, identified by using immunohistochemical staining, confirming the diagnosis of a PMT mixed connective tissue variant. Curettage of the tumor was performed, and the defects were filled with bone allografts. The hip joint was reconstructed with total hip arthroplasty using a Muller support ring. To our knowledge, this report represents the first documented case of massive PMT of the acetabulum causing TIO.

Original languageEnglish
Pages (from-to)906-910
Number of pages5
JournalModern Rheumatology
Volume28
Issue number5
DOIs
Publication statusPublished - Sep 3 2018

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Acetabulum
Neoplasms
Hip
Hypophosphatemia
Ergocalciferols
Bone and Bones
Osteomalacia
Curettage
Hip Joint
Arthralgia
Back Pain
Serum
Arthroplasty
Connective Tissue
Phosphorus
Allografts
Magnetic Resonance Imaging
Oncogenic osteomalacia
Staining and Labeling
Biopsy

All Science Journal Classification (ASJC) codes

  • Rheumatology

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Tumor-induced osteomalacia caused by a massive phosphaturic mesenchymal tumor of the acetabulum : A case report. / Nakamura, Kimitaka; Ohishi, Masanobu; Matsunobu, Tomoya; Nakashima, Yasuharu; Sakamoto, Akio; Maekawa, Akira; Oda, Yoshinao; Iwamoto, Yukihide.

In: Modern Rheumatology, Vol. 28, No. 5, 03.09.2018, p. 906-910.

Research output: Contribution to journalArticle

Nakamura, Kimitaka ; Ohishi, Masanobu ; Matsunobu, Tomoya ; Nakashima, Yasuharu ; Sakamoto, Akio ; Maekawa, Akira ; Oda, Yoshinao ; Iwamoto, Yukihide. / Tumor-induced osteomalacia caused by a massive phosphaturic mesenchymal tumor of the acetabulum : A case report. In: Modern Rheumatology. 2018 ; Vol. 28, No. 5. pp. 906-910.
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