title: Bilateral subtrochanteric fractures in tumour-induced osteomalacia caused by a nasal haemangiopericytoma.
abstract: Bilateral insufficiency fractures of the proximal femur often have a pathological basis. Diagnosis of rare causes of insufficiency fractures can be challenging. Tumour-induced osteomalacia (TIO) is a rare paraneoplastic syndrome of mesenchymal tumours which leads to hypophosphataemia and osteomalacia. Suspected pathological fractures should be investigated thoroughly including a fasting serum phosphate level. Further investigations should include serum levels of fibroblast growth factor 23 (FGF23) which is a peptide hormone secreted by mesenchymal tumours. Available imaging modalities include Octreotide scanning which detects somatostatin receptors commonly expressed on mesenchymal tumours. After localisation and resection of the tumour, a full recovery from TIO is achievable.
authors.affiliation: Trauma and Orthopaedics Department, Cheltenham General Hospital, Cheltenham, UK. henryburnand@yahoo.co.uk
authors.forename: Henry
authors.initials: H
authors.lastname: Burnand
authors.forename: Abigail
authors.initials: A
authors.lastname: Samuels
authors.forename: Ian
authors.initials: I
authors.lastname: Hagan
authors.forename: Nitin
authors.initials: N
authors.lastname: Sawant
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mutimer
mesh_terms: D000089703:Fibroblast Growth Factor-23; D005593:Fracture Fixation, Internal; D015775:Fractures, Stress / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006393:Hemangiopericytoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006620:Hip Fractures / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D010018:Osteomalacia / Q000209:etiology* / Q000473:pathology; D010257:Paraneoplastic Syndromes / Q000209:etiology* / Q000473:pathology; D016896:Treatment Outcome