Vol 63, No 3 (2012)
Case report
Published online: 2012-06-28
Oncogenic osteomalacia should be considered in hypophosphatemia, bone pain and pathological fractures
Endokrynol Pol 2012;63(3):234-238.
Abstract
The clinical manifestation of oncogenic osteomalacia includes bone pain, pathological fractures, general fatigue and muscle weakness. Such
unspecific symptoms hinder the establishment of a proper diagnosis which very often requires long-lasting investigations with many
diagnostic imaging methods. Here, we discuss difficulties in the diagnosis of oncogenic osteomalacia using the example of our own clinical
case: a 56 year-old woman with a history of pain in the left hip and two years of walking difficulties. A plain radiograph and CT scan
revealed pathological fractures. Multiple myeloma, primary hyperparathyroidism and bone metastatic disease were excluded. Routine
laboratory tests showed elevated alkaline phosphatase and a mild degree of hypophosphatemia. CT and MR imaging confirmed the
presence of a pathological mass in the thorax. Tumour excision and histopathological test results revealed the diagnosis of a phosphaturic
mesenchymal tumour. Our case, showing the clinical course of the disease from the symptoms manifested at the beginning to the
establishment of the diagnosis, can serve as a model illustration of the diagnostic struggle involved with oncogenic osteomalacia.
Keywords: oncogenic osteomalaciatumour-induced osteomalaciahypophosphatemiabone painpathological fractures