title: A case of oncogenic osteomalacia due to occult nasal sinus tumor.
abstract: This paper shows a case of oncogenic osteomalacia in a 35-year-old man who presented with a 2-year history of generalized pain and progressive weakness of lower limbs, eventually became bed bound. At admission he had severe hip pain resulting from atraumatic femoral neck fractures. Laboratory investigations revealed hypophosphatemia, hyperphosphaturia, normocalcemia, elevated alkaline phosphatase, and normal serum levels of parathormone and 25-hydroxyvitamin D. Serum FGF-23 was elevated. Imaging showed osteoporosis and insufficiency fractures of the femoral neck. Whole body functional imaging failed to reveal any areas of increased activity. However, on computed tomography (CT) and magnetic resonance (MR) imaging, a tumor was discovered at left nasal cavity. The patient was treated with phosphate supplements and vitamin D, but his hypophosphatemia persisted. The tumor was surgically removed. Histologically, the tumor was diagnosed as variant of a sinonasal hemangiopericytoma-like tumor. After surgery, his symptoms were relieved and biochemical parameters normalized.
authors.affiliation: Department of Endocrinology and Metabolism, IPGMER and SSKM Hospital, Kolkata, West Bengal, India.
authors.forename: Sayantan
authors.initials: S
authors.lastname: Ray
authors.affiliation: Department of Endocrinology and Metabolism, IPGMER and SSKM Hospital, Kolkata, West Bengal, India.
authors.forename: Partha Pratim
authors.initials: PP
authors.lastname: Chakraborty
authors.affiliation: Department of Endocrinology and Metabolism, IPGMER and SSKM Hospital, Kolkata, West Bengal, India.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Biswas
authors.affiliation: Department of Endocrinology and Metabolism, IPGMER and SSKM Hospital, Kolkata, West Bengal, India.
authors.forename: Sujoy
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Department of Endocrinology and Metabolism, IPGMER and SSKM Hospital, Kolkata, West Bengal, India.
authors.forename: Satinath
authors.initials: S
authors.lastname: Mukhopadhyay
authors.affiliation: Department of Endocrinology and Metabolism, IPGMER and SSKM Hospital, Kolkata, West Bengal, India.
authors.forename: Subhankar
authors.initials: S
authors.lastname: Chowdhury
keywords: fibroblast growth factor 23; hemangiopericytoma; hypophosphatemia; nasal tumor; oncogenic osteomalacia