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22.07.2023 | Original Article

Diagnosis and management of tumor-induced osteomalacia: a single center experience

verfasst von: Hulya Hacisahinogullari, Sakin Tekin, Seher Tanrikulu, Goktug Saribeyliler, Gulsah Yenidunya Yalin, Bilge Bilgic, Emine Goknur Isik, Ahmet Salduz, Samuray Tuncer, Nurdan Gul, Ayse Kubat Uzum, Ferihan Aral, Refik Tanakol, Ozlem Soyluk Selcukbiricik

Erschienen in: Endocrine | Ausgabe 2/2023

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Abstract

Purpose

The aim of this study is to review the clinical and laboratory characteristics, diagnostic and treatment modalities of tumor-induced osteomalacia (TIO) cases managed in a single center.

Material methods

Demographic and clinical features, biochemical findings, diagnostic procedures, treatment modalities, and outcomes of nine patients who had the diagnosis of TIO were reviewed retrospectively.

Results

Mean age of the study group (F/M: 4/5) was 45.8 ± 10.8 years, and mean time from the onset of symptoms to diagnosis was 4.7 ± 2.8 years. The clinical manifestations were muscle weakness and difficulty in walking (8/9), hip pain (3/9), multiple fractures (2/9), stress fracture (2/9). Mean plasma phosphorus concentration was 1.28 ± 0.4 mg/dl at presentation. We performed radionuclide imaging modalities (18F-FDG PET/CT, Ga68-DOTATATE PET/CT, octreotide scintigraphy) in seven of nine patients, and tumor was detected in all. Lower extremity (n = 6; %67), head region (n = 2; %22) and thorax (n = 1; %11) were the tumor locations of our cases. Eight patients underwent surgery and remission was achieved postoperatively in all of the operated patients and plasma phosphorus level normalized in 4 ± 2 days. Pathological examination revealed mesenchymal tumors with different subtypes. Recurrence occurred in three patients at 13 ± 10.5 months after the first surgery. Two patients were reoperated and radiotherapy was also performed in one of them.

Conclusion

Hypophosphatemia necessitates careful evaluation for the etiology. TIO is one of the important causes of adult-onset hypophosphatemic osteomalacia. Diagnosis of TIO is essential because the laboratory and clinical findings resolve after appropriate treatment.

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Titel: Diagnosis and management of tumor-induced osteomalacia: a single center experience
verfasst von: Hulya Hacisahinogullari
Sakin Tekin
Seher Tanrikulu
Goktug Saribeyliler
Gulsah Yenidunya Yalin
Bilge Bilgic
Emine Goknur Isik
Ahmet Salduz
Samuray Tuncer
Nurdan Gul
Ayse Kubat Uzum
Ferihan Aral
Refik Tanakol
Ozlem Soyluk Selcukbiricik
Publikationsdatum: 22.07.2023
Verlag: Springer US
Erschienen in: Endocrine / Ausgabe 2/2023
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-023-03450-3

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Diagnosis and management of tumor-induced osteomalacia: a single center experience