Oncogenic osteomalacia: loss of hypophosphatemia might be the key to avoid misdiagnosis

Arq Bras Endocrinol Metabol. 2012 Nov;56(8):570-3. doi: 10.1590/s0004-27302012000800018.

Abstract

Diagnosing oncogenic osteomalacia is still a challenge. The disorder is characterized by osteomalacia caused by renal phosphate wasting and low serum concentration of 1,25-dihydroxyvitamin D3 occurring in the presence of a tumor that produces high levels of fibroblast growth factor 23. However, it is possible that the disease is much more misdiagnosed than rare. We present the case of a 42-year-old man with a long-term history of undiagnosed progressive muscle weakness. His laboratory results mainly showed low serum phosphate. Surgical removal of a nasal hemangiopericytoma that had been diagnosed five years earlier, brought him to a symptom-free condition. Even though knowing the underlying etiology would explain his osteomalacia, the patient sought medical help from countless physicians for five consecutive years, and only after adequate treatment a rewarding outcome was achieved.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnostic Errors
  • Hemangiopericytoma / complications*
  • Hemangiopericytoma / diagnosis
  • Humans
  • Male
  • Neoplasms, Connective Tissue / diagnosis
  • Neoplasms, Connective Tissue / etiology*
  • Nose Neoplasms / complications*
  • Nose Neoplasms / diagnosis
  • Osteomalacia
  • Paraneoplastic Syndromes

Supplementary concepts

  • Oncogenic osteomalacia