title: Oncogenic osteomalacia: loss of hypophosphatemia might be the key to avoid misdiagnosis.
abstract: Diagnosing oncogenic osteomalacia is still a challenge. The disorder is characterized by osteomalacia caused by renal phosphate wasting and low serum concentration of 1,25-dihydroxyvitamin D3 occurring in the presence of a tumor that produces high levels of fibroblast growth factor 23. However, it is possible that the disease is much more misdiagnosed than rare. We present the case of a 42-year-old man with a long-term history of undiagnosed progressive muscle weakness. His laboratory results mainly showed low serum phosphate. Surgical removal of a nasal hemangiopericytoma that had been diagnosed five years earlier, brought him to a symptom-free condition. Even though knowing the underlying etiology would explain his osteomalacia, the patient sought medical help from countless physicians for five consecutive years, and only after adequate treatment a rewarding outcome was achieved.
authors.affiliation: Department of Medicine, Faculdade de Medicina de Botucatu, Universidade Estadual de São Paulo, Botucatu, SP, Brazil. chang.cv@gmail.com
authors.forename: Claudia V
authors.initials: CV
authors.lastname: Chang
authors.forename: Sandro J
authors.initials: SJ
authors.lastname: Conde
authors.forename: Renata A M
authors.initials: RA
authors.lastname: Luvizotto
authors.forename: Vânia S
authors.initials: VS
authors.lastname: Nunes
authors.forename: Milla C
authors.initials: MC
authors.lastname: Bonates
authors.forename: Andre C
authors.initials: AC
authors.lastname: Felicio
authors.forename: Susan C
authors.initials: SC
authors.lastname: Lindsey
authors.forename: Flávia H
authors.initials: FH
authors.lastname: Moraes
authors.forename: José V
authors.initials: JV
authors.lastname: Tagliarini
authors.forename: Glaucia M F S
authors.initials: GM
authors.lastname: Mazeto
authors.forename: Peter
authors.initials: P
authors.lastname: Kopp
authors.forename: Célia R
authors.initials: CR
authors.lastname: Nogueira
mesh_terms: D000328:Adult; D003951:Diagnostic Errors; D006393:Hemangiopericytoma / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D009372:Neoplasms, Connective Tissue / Q000175:diagnosis / Q000209:etiology*; D009669:Nose Neoplasms / Q000150:complications* / Q000175:diagnosis; D010018:Osteomalacia; D010257:Paraneoplastic Syndromes