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Inicio Revista Colombiana de Reumatología (English Edition) Oncogenic osteomalacia secondary to phosphaturic mesenchymal tumor of the foot
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Vol. 27. Issue 3.
Pages 210-214 (July - September 2020)
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Vol. 27. Issue 3.
Pages 210-214 (July - September 2020)
Case report
DOI: 10.1016/j.rcreue.2019.09.001
Oncogenic osteomalacia secondary to phosphaturic mesenchymal tumor of the foot
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Sandra Garrote-Corrala, Walter Alberto Sifuentes-Giraldoa,
Corresponding author
albertosifuentesg@gmail.com

Corresponding author.
, María Eugenia Reguero-Callejasb, Mónica Vázquez-Díaza
a Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, Spain
b Servicio de Patología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Abstract

Oncogenic osteomalacia is a paraneoplastic metabolic syndrome characterised by a low phosphates in the blood due to renal phosphate losses with inadequately normal or low vitamin D levels. This disorder is associated with the release of tumour cell-secreted phosphaturic factor, most notably fibroblast growth factor 23 (FGF-23). The neoplasms related to oncogenic osteomalacia are usually small tumours of mesenchymal lineage, and they may be difficult to locate in the physical examination in some cases, due to their size and inaccessible location. The case is presented of a patient who developed vertebral and hip fractures due to oncogenic osteomalacia associated with a phosphaturic mesenchymal tumour of the deep fat tissue in the sole of the foot. This was finally diagnosed after 3 years of the onset of symptoms after being located by bone scintigraphy with Indium 111-labelled pentetreotide and magnetic resonance imaging.

Keywords:
Oncogenic osteomalacia
Tumour-induced osteomalacia
Phosphaturic mesenchymal tumour
Fibroblast growth factor 23
Resumen

La osteomalacia oncogénica es un síndrome metabólico paraneoplásico caracterizado por hipofosfatemia debida a la pérdida renal de fosfato con niveles inadecuadamente normales o bajos de vitamina D. Este trastorno está asociado con la liberación de factores fosfatúricos por células tumorales, especialmente el factor de crecimiento fibrolástico 23 (FGF23). Las neoplasias relacionadas con la osteomalacia oncogénica suelen ser tumores pequeños de linaje mesenquimatoso y pueden ser difíciles de localizar en algunos casos debido a su tamaño y ubicación poco accesible al examen físico. Presentamos a un paciente que desarrolló fracturas vertebrales y de cadera debido a osteomalacia oncogénica asociada con un tumor mesenquimatoso fosfatúrico del tejido graso profundo de la planta del pie, que finalmente se diagnosticó después de 3 años del inicio de los síntomas cuando el tumor pudo ser localizado por el rastreo gammagráfico óseo con pentatreótido marcado con Indio-111 y las imágenes de resonancia magnética nuclear.

Palabras clave:
Osteomalacia oncogénica
Osteomalacia inducida por tumor
Tumor mesenquimatoso fosfatúrico
Factor de crecimiento fibroblástico 23

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