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Advanced prostate cancer as a cause of oncogenic osteomalacia: an underdiagnosed condition

Supportive Care in Cancer volume 20, pages 2195–2197 (2012)Cite this article

Abstract

Purpose

Tumor-induced osteomalacia (TIO) is a paraneoplastic bone mineral disturbance related to fibroblast growth factor 23 (FGF23) overproduction by the tumor, usually from mesenchymal origin. Such condition leads to high phosphate renal wasting and, consequently, to cumbersome symptoms as weakness, bone pain, and fractures.

Method

Case report.

Result

We report a case of an advanced castration-refractory prostate cancer patient, which developed severe hypophosphatemia with elevated phosphate excretion fraction. TIO was suspected, and increased levels of FGF23 reinforced such diagnosis. The patient died 4 months after being diagnosed with TIO.

Conclusion

This case suggests that TIO has a dismal prognosis in prostate cancer patients. The clinical oncology community must be aware about such disturbance that can be present in those patients with weakness, bone pain, and hypophosphatemia.

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Conflicts of interest

The authors declare that they have no conflict of interest to disclose related to this manuscript. Here, we state that the authors have full control of all the primary data here reported, and they agree to allow the journal to review all data.

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Affiliations

  1. Clinical Oncology, Instituto do Câncer do Estado de São Paulo, Av. Dr. Arnaldo 251, 5th Floor, São Paulo, 01246-000, Brazil

    Milena Perez Mak, Paulo Marcelo Gehm Hoff & Gilberto de Castro Junior

  2. Nephrology, Instituto do Câncer do Estado de São Paulo, Av. Dr. Arnaldo 251, São Paulo, 01246-000, Brazil

    Verônica Torres da Costa e Silva & Luis Yu

  3. Endocrinology, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 155, PAMB 2nd Floor, Bldg. 6, São Paulo, 05403-900, Brazil

    Regina Matsunaga Martin

  4. Endocrinology, Instituto do Câncer do Estado de São Paulo, Av. Dr. Arnaldo 251, São Paulo, 01246-000, Brazil

    Antonio Marcondes Lerario

Authors
  1. Milena Perez Mak
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  2. Verônica Torres da Costa e Silva
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  3. Regina Matsunaga Martin
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  4. Antonio Marcondes Lerario
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  5. Luis Yu
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  6. Paulo Marcelo Gehm Hoff
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  7. Gilberto de Castro Junior
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Corresponding author

Correspondence to Gilberto de Castro Junior.

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Mak, M.P., da Costa e Silva, V.T., Martin, R.M. et al. Advanced prostate cancer as a cause of oncogenic osteomalacia: an underdiagnosed condition. Support Care Cancer 20, 2195–2197 (2012). https://doi.org/10.1007/s00520-012-1474-z

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  • DOI: https://doi.org/10.1007/s00520-012-1474-z

Keywords

  • Tumor-induced osteomalacia
  • Prostate cancer
  • Bone metastasis
  • Hypophosphatemia
  • FGF23