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Tumor-Induced Osteomalacia

  • Mark Anthony SandovalEmail author
Chapter

Abstract

Tumor-induced osteomalacia is an acquired paraneoplastic disease of the bone that occurs due to oversecretion of the phosphaturic hormone FGF23 by a functioning tumor. Clinical features are similar to other causes of osteomalacia such as bone pains, bone deformities, and bone weakness. The underlying causative tumor is usually asymptomatic. Laboratory hallmarks are hypophosphatemia, phosphaturia, and low 1,25 dihydroxy vitamin D. The causative tumor must be located by a combination of physical examination and functional and anatomical imaging tests. Cure is possible and prognosis is favorable when the causative tumor is completely excised. When surgery is not possible or carries significant postoperative morbidity, a variety of pharmacologic agents and tumor-directed therapies can be employed.

Keywords

Tumor-induced osteomalacia Oncogenic osteomalacia Paraneoplastic syndrome Phosphatonin Fibroblast growth factor 23 

Abbreviations

CT

Computed tomography

DOTANOC

1,4,7,10-Tetraazacyclododecane -D-Phe1-1-Nal3-octreotide

DOTATATE

1,4,7,10-Tetraazacyclododecane-1,4,7,10-tetraacetic acid octreotate

DOTATOC

1,4,7,10-Tetraazacyclododecane-N,N,N,N-tetraacetic-acid-D-Phe1 -Tyr3 –octreotide

FDG

Fluorodeoxyglucose

FGF

Fibroblast growth factor

HYNIC-TOC

Hydrazinonicotinyl-Tyr3-Octreotide

MEPE

Matrix extracellular phosphoglycoprotein

MIBI

Methoxyisobutylisonitrile

MRI

Magnetic resonance imaging

NPT

Sodium-phosphate cotransporter

OOM

Oncogenic osteomalacia

PET

Positron emission tomography

PMT

Phosphaturic mesenchymal tumor

PMTMCT

Phosphaturic mesenchymal tumor, mixed connective tissue variant

sFRP-4

Secreted frizzled-related protein 4

SPECT

Single photon emission computed tomography

TIO

Tumor-induced osteomalacia

TmP/GFR

Tubular maximum reabsorption of phosphate corrected for glomerular filtration rate

TRP

Tubular phosphate reabsorption

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Physiology and Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Philippine General HospitalUniversity of the Philippines ManilaManilaPhilippines

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