Occult nasal sinus tumours causing oncogenic osteomalacia.
Oncogenic osteomalacia (OOM) is a rare but curable cause of metabolic bone disease. We report 9 patients with OOM, including 2 patients with occult nasal sinus tumours and 1 in whom a progressive increase in the post-operative FGF23 level heralded the development of metastatic pulmonary disease. The median duration of symptoms before definitive surgical treatment was 6 years, and in one patient was more than 10 years. This series demonstrates that careful imaging of the nasal sinuses should be part of the work-up of cases of oncogenic osteomalacia, that serum FGF23 can be helpful in both diagnosis and monitoring treatment outcomes, and emphasizes that serum phosphate should be measured in patients with metabolic bone disease and/or unexplained musculoskeletal symptoms.
Kenealy
Helen
H
Department of Endocrinology, Auckland City Hospital, Park Road, Grafton, Auckland, New Zealand. HKenealy@adhb.govt.nz
Holdaway
Ian
I
Grey
Andrew
A
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D006393:Hemangiopericytoma / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010018:Osteomalacia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000378:metabolism; D010255:Paranasal Sinus Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D010256:Paranasal Sinuses; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23