A case of oncogenic osteomalacia with preoperative secondary hyperparathyroidism: description of the biochemical response of FGF23 to octreotide therapy and surgery.
Oncogenic osteomalacia is a rare condition characterized by a low serum phosphate, reduced tubular reabsorption of phosphate and a low or inappropriately normal 1,25 dihydroxyvitamin D and is usually secondary to a phosphaturic mesenchymal tumor. Complete tumor resection results in resolution of all features. We report a patient with oncogenic osteomalacia and concurrent secondary hyperparathyroidism. Serum phosphate failed to normalize preoperatively with octreotide therapy, although this treatment did suppress serum FGF23. The postoperative course was distinguished by marked hyperphosphatemia that was associated with elevated serum 1,25 dihydroxyvitamin D concentrations.
Elston
Marianne S
MS
Department of Endocrinology, Waikato Hospital, Private Bag 3200, Hamilton, New Zealand.
Stewart
Inge J
IJ
Clifton-Bligh
Roderick
R
Conaglen
John V
JV
D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001842:Bone and Bones / Q000000981:diagnostic imaging; D003131:Combined Modality Therapy; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000032:analysis / Q000097:blood*; D006801:Humans; D006961:Hyperparathyroidism / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D015282:Octreotide / Q000627:therapeutic use*; D010018:Osteomalacia / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D010710:Phosphates / Q000097:blood; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; C000717427:FGF23 protein, human; D010710:Phosphates; D014807:Vitamin D; D005346:Fibroblast Growth Factors; C097949:1,25-dihydroxyvitamin D; D000089703:Fibroblast Growth Factor-23; D015282:Octreotide