title: Six-year follow-up of a characteristic osteolytic lesion in a patient with tumor-induced osteomalacia.
abstract: OBJECTIVE
  Tumor-induced osteomalacia is a rare paraneoplastic syndrome characterized by hypophosphatemia and inappropriately normal or low 1,25-dihydroxyvitamin D.
  
  
  METHODS
  Here, we report a 6-year postoperative follow-up of a patient with oncogenic osteomalacia with a distinctive skeletal manifestation. The latter was characterized by an almost linear lytic lesion of a few millimeters with irregular borders, mainly involving the trabecular compartment but extending into cortical shell, located in the middle third of the right fibula. Six years after tumor resection, a sclerotic repair with a complete recovery was observed. Furthermore, we monitored a striking increase in bone mineral density throughout the observation period, reaching a peak of 73% over basal values at lumbar spine after 2 years; at total femur and radius, the peak was 47.5 and 4.6% respectively, after 4 years from tumor resection.
  
  
  CONCLUSIONS
  We report for the first time that an osteolytic lesion may be part of the skeletal involvement in tumor-induced osteomalacia.
authors.affiliation: Departments ofInternal Medicine and Medical Disciplines.
authors.forename: Sara
authors.initials: S
authors.lastname: Piemonte
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Romagnoli
authors.forename: Cristiana
authors.initials: C
authors.lastname: Cipriani
authors.forename: Federica
authors.initials: F
authors.lastname: De Lucia
authors.forename: Roberta
authors.initials: R
authors.lastname: Pilotto
authors.forename: Daniele
authors.initials: D
authors.lastname: Diacinti
authors.forename: Jessica
authors.initials: J
authors.lastname: Pepe
authors.forename: Salvatore
authors.initials: S
authors.lastname: Minisola
mesh_terms: D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002136:Calcium, Dietary / Q000627:therapeutic use; D002762:Cholecalciferol / Q000627:therapeutic use; D003131:Combined Modality Therapy; D019587:Dietary Supplements; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging; D015775:Fractures, Stress / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000178:diet therapy / Q000503:physiopathology* / Q000601:surgery; D009372:Neoplasms, Connective Tissue / Q000178:diet therapy / Q000503:physiopathology* / Q000601:surgery; D010018:Osteomalacia; D010257:Paraneoplastic Syndromes; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D011859:Radiography; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary; D002762:Cholecalciferol