title: FGF23-Associated Tumor-Induced Osteomalacia in a Patient With Small Cell Carcinoma: A Case Report and Regulatory Mechanism Study.
abstract: Tumor-induced osteomalacia (TIO) is typically caused by phosphaturic mesenchymal tumor (PMT) that secretes the phosphaturic hormone, fibroblast growth factor-23 (FGF23), resulting in decreased phosphate reabsorption in kidneys, hypophosphatemia, and finally osteomalacia. Rare cases of malignant tumor manifesting with TIO other than PMT had been reported, although in most of these reports, except one, circulating FGF23 levels were not evaluated and tissue expressing of FGF23 was not confirmed. In this article, we report a case of TIO in a patient with pulmonary small cell carcinoma with liver metastasis. The patient manifested with hypophosphatemia. His circulating level of FGF23 was markedly increased. The expression of FGF23 in tumor cells was confirmed. Furthermore, the regulatory mechanism of FGF23 in this patient was also investigated.
authors.affiliation: Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Sauder
authors.affiliation: University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Szymon
authors.initials: S
authors.lastname: Wiernek
authors.affiliation: University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Xumin
authors.initials: X
authors.lastname: Dai
authors.affiliation: University of California at Los Angeles, CA, USA.
authors.forename: Renata
authors.initials: R
authors.lastname: Pereira
authors.affiliation: VA New Jersey Medical Center, East Orange, NJ, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Yudd
authors.affiliation: Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Charvi
authors.initials: C
authors.lastname: Patel
authors.affiliation: Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Golden
authors.affiliation: VA New Jersey Medical Center, East Orange, NJ, USA.
authors.forename: Shahida
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: VA New Jersey Medical Center, East Orange, NJ, USA.
authors.forename: Jin
authors.initials: J
authors.lastname: Choe
authors.affiliation: VA New Jersey Medical Center, East Orange, NJ, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Chang
authors.affiliation: VA New Jersey Medical Center, East Orange, NJ, USA.
authors.forename: Slawomir
authors.initials: S
authors.lastname: Sender
authors.affiliation: VA New Jersey Medical Center, East Orange, NJ, USA dcai2@hotmail.com.
authors.forename: Donghong
authors.initials: D
authors.lastname: Cai
mesh_terms: D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000096:biosynthesis*; D006801:Humans; D017674:Hypophosphatemia / Q000209:etiology; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009372:Neoplasms, Connective Tissue / Q000209:etiology*; D010018:Osteomalacia; D010257:Paraneoplastic Syndromes; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055752:Small Cell Lung Carcinoma / Q000150:complications*
chemical_list: C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23
keywords: FGF23; small cell carcinoma; tumor-induced osteomalacia; wnt signaling pathway