title: Oncogenic osteomalacia in a case with a maxillary sinus mesenchymal tumor.
abstract: We herein describe the rare case of a 41-year-old woman with oncogenic osteomalacia due to a tumor in the maxillary sinus who presented with chronic general pain that had been gradually deteriorating. The patient's laboratory findings revealed hypophosphatemia due to renal phosphate wasting, an inappropriately low serum 1 alpha,25-dihydroxyvitamin D3 level for hypophosphatemia and an unusually high serum level of fibroblast growth factor 23 (FGF23). The causative tumor was surgically removed, resulting in a rapid resolution of the patient's biochemical abnormalities. An improvement of the abnormal multiple deposits on (99)Technetium-methylene diphosphonate bone scintigraphy and an increase in the bone metabolism markers suggested the development of bone remodeling within 49 days after the operation. The pathologic diagnosis of the tumor was a "phosphaturic mesenchymal tumor, mixed with a connective tissue variant." The expression of FGF23 was demonstrated in the tumor by the immunohistochemical techniques and a Western analysis.
authors.affiliation: Department of Diabetes and Endocrine Medicine, Kagoshima University Hospital, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan. nb-koriyama@kagomc2.hosp.go.jp
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Koriyama
authors.forename: Kengo
authors.initials: K
authors.lastname: Nishimoto
authors.forename: Takuro
authors.initials: T
authors.lastname: Kodama
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Nakazaki
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kurono
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yoshida
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: D000328:Adult; D018211:Chondrosarcoma, Mesenchymal / Q000150:complications*; D005260:Female; D000089703:Fibroblast Growth Factor-23; D006801:Humans; D008444:Maxillary Sinus Neoplasms / Q000150:complications*; D010018:Osteomalacia / Q000209:etiology*; D013997:Time Factors