Reversible avascular necrosis of the femoral head in tumor-induced osteomalacia.
OBJECTIVE
To document the course and reversal of avascular necrosis of the femoral heads (ANFH) in a 27-year-old woman with tumor-induced osteomalacia (TIO).


METHODS
We describe clinical, biochemical, and magnetic resonance imaging changes in a patient who sought medical assistance because of pain in her back, hips, and knees and an enlarging mass on her right thigh.


RESULTS
The patient proved to have TIO, an unusual condition characterized by humorally controlled renal phosphate wasting, low to undetectable levels of 1,25-dihydroxyvitamin D(3), and osteomalacia. Eleven months after removal of a small spindle cell tumor of the right thigh and without other treatment, complete clinical and biochemical remission was observed, and the magnetic resonance images revealed resolution of the ANFH.


CONCLUSIONS
Prompt treatment of ANFH in TIO can lead to complete radiologic and clinical remission.
Sharkis
D H
DH
Eastern Virginia Medical School, Norfolk, Virginia 23505-9968, USA.
Devereux
J P
JP
Chako
A C
AC
Estep
H L
HL