title: Tumor-induced hypophosphatemic osteomalacia diagnosed by the combinatory procedures of magnetic resonance imaging and venous sampling for FGF23.
abstract: This report describes a 37-year-old man with tumor-induced osteomalacia (TIO). The patient had hypophosphatemia and elevated fibroblast growth factor 23 (FGF23) in the peripheral blood. Magnetic resonance imaging detected an abnormal mass in the left greater trochanter. Venous sampling revealed a significantly higher level of FGF23 in the left common iliac vein (proximal to the tumor), verifying that the tumor is responsible for TIO. The serum level of FGF23 decreased and symptoms improved after removal of the tumor. The combined diagnostic procedures of MRI and venous sampling for FGF23 effectively detected the tumor responsible for TIO.
authors.affiliation: The First Department of Medicine, Wakayama Medical University, Wakayama. tnasu@wakayama-med.ac.jp
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Nasu
authors.forename: Seigo
authors.initials: S
authors.lastname: Kurisu
authors.forename: Shohei
authors.initials: S
authors.lastname: Matsuno
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Tatsumi
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Kakimoto
authors.forename: Masato
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Nakano
authors.forename: Hisao
authors.initials: H
authors.lastname: Wakasaki
authors.forename: Hiroto
authors.initials: H
authors.lastname: Furuta
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nishi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sasaki
authors.forename: Hisanori
authors.initials: H
authors.lastname: Suzuki
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Ito
authors.forename: Seiji
authors.initials: S
authors.lastname: Fukumoto
authors.forename: Kishio
authors.initials: K
authors.lastname: Nanjo
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging; D005268:Femoral Vein; D005269:Femur / Q000473:pathology; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D017674:Hypophosphatemia / Q000209:etiology*; D008297:Male; D010018:Osteomalacia / Q000209:etiology*; D010257:Paraneoplastic Syndromes / Q000209:etiology*
chemical_list: C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23