Phosphaturic Mesenchymal Tumor with Symptoms Related to Osteomalacia that Appeared One Year after Tumorectomy

Katsunobu Yoshioka, Rie Nagata, Mami Ueda, Toshimasa Yamaguchi, Yoshio Konishi, Masayuki Hosoi, Takeshi Inoue, Kazuhiro Yamanaka, Yoshiyasu Iwai, Toshihiko Sato
2006 Internal medicine (Tokyo. 1992)  
A 45-year-old man was admitted to our hospital because of bone pain and hypophosphatemia. He had undergone surgery 2 years previously for a "benign unclassified mesenchymal tumor" in the skull, but there were no clinical symptoms related to osteomalacia. His laboratory examination revealed low serum phosphate, high alkaline phosphatase, and normal calcium levels. The diagnosis of tumor-induced osteomalacia due to phosphaturic mesenchymal tumor mixed connective tissue variant (PMTMCT) was made
more » ... (PMTMCT) was made by reexamining the pathologic specimens. Oral supplementation with phosphate and 1-25-dihydroxyvitamin D relieved his clinical symptoms and laboratory values returned to normal. However, subcutaneous administration of octreotide had no clinical effect. Clinicians and pathologists should be aware of the existence of PMTMCT especially nonphosphaturic or asymptomatic variants of this disorder. A 45-year-old man was admitted to our hospital on November 22, 2005, because of bone pain and hypophosphatemia. In June 2003, he had been admitted to the neurosurgical floor complaining of posterior neck pain and left hypoglossal nerve palsy. Clinical evidence of osteomalacia, including bone pain, was absent. Laboratory examination showed low serum phosphate (1.9 mg/dl), normal alkaline phosphatase (212 IU/l), and normal calcium (9.1 mg/dl) levels. T1-weighted magnetic resonance imaging (MRI) re-
doi:10.2169/internalmedicine.45.1797 pmid:17106161 fatcat:aldxmcxcbjat3lwwskpq4sfrou