TY - JOUR
T1 - Clinical and bone density outcomes of tumor-induced osteomalacia after treatment
AU - Umphrey, Lisa G.
AU - Whitaker, Michael D.
AU - Bosch, E. Peter
AU - Cook, Curtiss B.
PY - 2007/9
Y1 - 2007/9
N2 - Objective: To report the outcomes of tumor-induced osteomalacia after treatment, particularly related to recovery of bone mass. Methods: We review the clinical course of a 61-year-old man extremely debilitated from multiple fractures and neuromuscular weakness due to tumor-induced osteomalacia and report the changes in biochemical markers and bone density after removal of the causative neoplasm. Results: At the time of diagnosis, the patient's serum phosphorus and 1,25 dihydroxyvitamin D levels were depressed, and his fibroblast growth factor-23 level was markedly elevated. These values normalized 2 days after surgery and remained within their respective reference ranges 4 and 12 months after resection of a mesenchymal tumor. Lumbar bone density values (T-scores) were 0.445 g/cm2 (-5.9) preoperatively, 0.939 g/cm 2 (-1.4) 4 months after surgery, and 1.152 g/cm2 (0.7) 12 months after surgery. Left femoral neck values at the same time points were 0.525 g/cm2 (-3.0), 1.035 g/cm2 (-0.8), and 1.184 g/cm2 (1.9). Ultra-distal radius values at the same time points were 0.128 g/cm2 (-7.0), 0.191 g/cm2 (-5.9), and 0.259 g/cm2 (-4.8). In addition, he recovered neuromuscular function and was able to leave his wheelchair. Conclusion: Tumor-induced osteomalacia can be an extremely debilitating disease. With successful localization, identification, and resection of the neoplasm, bone mass and physical function can recover.
AB - Objective: To report the outcomes of tumor-induced osteomalacia after treatment, particularly related to recovery of bone mass. Methods: We review the clinical course of a 61-year-old man extremely debilitated from multiple fractures and neuromuscular weakness due to tumor-induced osteomalacia and report the changes in biochemical markers and bone density after removal of the causative neoplasm. Results: At the time of diagnosis, the patient's serum phosphorus and 1,25 dihydroxyvitamin D levels were depressed, and his fibroblast growth factor-23 level was markedly elevated. These values normalized 2 days after surgery and remained within their respective reference ranges 4 and 12 months after resection of a mesenchymal tumor. Lumbar bone density values (T-scores) were 0.445 g/cm2 (-5.9) preoperatively, 0.939 g/cm 2 (-1.4) 4 months after surgery, and 1.152 g/cm2 (0.7) 12 months after surgery. Left femoral neck values at the same time points were 0.525 g/cm2 (-3.0), 1.035 g/cm2 (-0.8), and 1.184 g/cm2 (1.9). Ultra-distal radius values at the same time points were 0.128 g/cm2 (-7.0), 0.191 g/cm2 (-5.9), and 0.259 g/cm2 (-4.8). In addition, he recovered neuromuscular function and was able to leave his wheelchair. Conclusion: Tumor-induced osteomalacia can be an extremely debilitating disease. With successful localization, identification, and resection of the neoplasm, bone mass and physical function can recover.
UR - http://www.scopus.com/inward/record.url?scp=35148861713&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=35148861713&partnerID=8YFLogxK
U2 - 10.4158/EP.13.5.458
DO - 10.4158/EP.13.5.458
M3 - Article
C2 - 17872346
AN - SCOPUS:35148861713
SN - 1530-891X
VL - 13
SP - 458
EP - 462
JO - Endocrine Practice
JF - Endocrine Practice
IS - 5
ER -