title: Oncogenic osteomalacia caused by occult nasal mesenchymal tumor: a monster in the cave.
abstract: Authors describe 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 bedbound. At admission, he had severe hip pain resulting from bilateral femoral neck fractures. Laboratory investigations revealed hypophosphatemia, hyperphosphaturia, normocalcemia, elevated alkaline phosphatase and normal serum levels of parathormone and 25-hydroxyvitamin D. Serum fibroblast growth factor 23 (FGF23) level was elevated. A radiographic skeletal survey showed osteoporosis and insufficiency fractures of the femoral neck. A whole-body functional imaging failed to reveal any areas of increased activity. However, on computed tomography and magnetic resonance imaging of the head and neck region, a tumor was discovered at left nasal cavity. The tumor was surgically removed. After surgery, his symptoms were relieved and biochemical parameters normalized. We stress that careful clinical examination including nose and paranasal sinuses may be rewarding in cases with hypophosphatemic osteomalacia.
authors.affiliation: Department of Endocrinology and Metabolism , Institute of Post Graduate Medical Education and Research (IPGMER) and SSKM Hospital , Kolkata , India.
authors.forename: Sayantan
authors.initials: S
authors.lastname: Ray
authors.affiliation: Department of Endocrinology and Metabolism , Institute of Post Graduate Medical Education and Research (IPGMER) and SSKM Hospital , Kolkata , India.
authors.forename: Partha Pratim
authors.initials: PP
authors.lastname: Chakraborty
authors.affiliation: Department of Endocrinology and Metabolism , Institute of Post Graduate Medical Education and Research (IPGMER) and SSKM Hospital , Kolkata , India.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Biswas
authors.affiliation: Department of Endocrinology and Metabolism , Institute of Post Graduate Medical Education and Research (IPGMER) and SSKM Hospital , Kolkata , India.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Beatrice
authors.affiliation: Department of Endocrinology and Metabolism , Institute of Post Graduate Medical Education and Research (IPGMER) and SSKM Hospital , Kolkata , India.
authors.forename: Sujoy
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Department of Endocrinology and Metabolism , Institute of Post Graduate Medical Education and Research (IPGMER) and SSKM Hospital , Kolkata , India.
authors.forename: Satinath
authors.initials: S
authors.lastname: Mukhopadhyay
authors.affiliation: Department of Endocrinology and Metabolism , Institute of Post Graduate Medical Education and Research (IPGMER) and SSKM Hospital , Kolkata , India.
authors.forename: Subhankar
authors.initials: S
authors.lastname: Chowdhury