Skip to main content Accessibility help
×
×
Home

Oncogenic osteomalacia from pterygopalatine fossa mass

  • C R Savage (a1) and L A Zimmer (a1)

Abstract

Introduction:

Oncogenic osteomalacia, or tumour-induced osteomalacia, is an uncommon cause of osteomalacia. It has been reported to occur in patients with hypophosphataemia due to excess renal phosphate excretion secondary to mesenchymal tumours. Occurrence of this pathological process in the head and neck is extremely rare.

Methods:

Case report and literature review.

Results:

We present a case of a 73-year-old woman with tumour-induced osteomalacia. She was initially followed by the endocrinologists for osteomalacia and pathological fractures. An indium-111 pentetreotide scan showed activity in the left pterygopalatine fossa. A mass was endoscopically resected, and the histopathological appearance was consistent with a haemangiopericytoma. Following surgery, the patient's hypophosphataemia and vitamin D deficiency corrected and her symptoms resolved.

Conclusions:

Oncogenic osteomalacia, or tumour-induced osteomalacia, is a rare entity in the head and neck. Current research is elucidating the mechanism by which phosphaturic wasting occurs. In most patients, symptoms resolve once the offending tumour is removed.

Copyright

Corresponding author

Address for correspondence: Dr Lee A Zimmer, University of Cincinnati, Department of Otolaryngology-Head and Neck Surgery, 231 Albert Sabin Way, ML 0528, Cincinnati, OH 45267, USA. Fax: +1 513 558 4477 E-mail: lee.zimmer@uc.edu

Footnotes

Hide All

Presented at the American Rhinologic Society Annual Meeting, 15 September 2007, Washington DC, USA.

Footnotes

References

Hide All
1 Jan de Beur, S. Tumor-induced osteomalacia. JAMA 2005;294:1260–7
2 McCrance, RA. Osteomalacia with Looser's nodes (milkman's syndrome) due to a raised resistance to vitamin D acquired about the age of 15 years. Q J Med 1947;16:3346
3 Crouzet, J, Mimoune, H, Beraneck, L, Juan, LH. Hypophosphatemic osteomalacia with plantar neurilemoma. A review of the literature (100 cases). Rev Rhum Engl Ed 1995;62:463–6
4 Folpe, AL, Fanburg-Smith, JC, Billings, SD, Bisceglia, M, Bertoni, F, Cho, JY et al. Most osteomalacia-associated mesenchymal tumors are a single histopathologic entity: an analysis of 32 cases and a comprehensive review of the literature. Am J Surg Pathol 2004;28:130
5 Gonzalez-Compta, X, Manos-Pujol, M, Foglia-Fernandez, M, Peral, E, Condom, E, Claveguera, T et al. Oncogenic osteomalacia: case report and review of head and neck associated tumours. J Laryngol Otol 1998;112:389–92
6 Inokuchi, G, Tanimoto, H, Ishida, H, Sugimoto, T, Yamauchi, M, Miyauchi, A et al. A paranasal tumor associated with tumor-induced osteomalacia. Laryngoscope 2006;116:1930–3
7 Sandhu, FA, Martuza, RL. Craniofacial hemangiopericytoma associated with oncogenic osteomalacia: case report. J Neurooncol 2000;46:241–7
8 Fuentealba, C, Pinto, D, Ballesteros, F, Pacheco, D, Boettiger, O, Soto, N et al. Oncogenic hypophosphatemic osteomalacia associated with a nasal hemangiopericytoma. J Clin Rheumatol 2003;9:373–9
9 Rhee, Y, Lee, JD, Shin, KH, Lee, HC, Huh, KB, Lim, SK. Oncogenic osteomalacia associated with mesenchymal tumour detected by indium-111 octreotide scintigraphy. Clin Endo 2001;54:551–4
10 Jan de Beur, SM, Streeten, EA, Civelek, AC, McCarthy, EF, Uribe, L, Marx, SJ et al. Localisation of mesenchymal tumours by somatostatin receptor imaging. Lancet 2002;359:761–3
11 Jonsson, KB, Zahradnik, R, Larsson, T, White, KE, Sugimoto, T, Imanishi, Y et al. Fibroblast growth factor 23 in oncogenic osteomalacia and X-linked hyperphosphatemia. N Engl J Med 2003;348:1656–63
12 Shimada, T, Mitzutani, S, Muto, T, Yoneya, T, Hino, R, Takeda, S et al. Cloning and characterization of FGF23 as a causative factor of tumor-induced osteomalacia. Proc Natl Acad Sci U S A 2001;98:6500–5
13 Bowe, A, Finnegan, R, Jan de Beur, SM, Cho, J, Levine, MA, Kumar, R et al. FGF23 inhibits phosphate transport in vitro and is a substrate for the PHEX endopeptidase. Biochem Biophys Res Commun 2001;284:977–81
14 Shimada, T, Urakawa, I, Yamazaki, Y, Hasegawa, H, Hino, R, Yoneya, T et al. FGF-23 transgenic mice demonstrate hypophosphatemic rickets with reduced expression of sodium phosphate cotransporter type IIa. Biochem Biophys Res Commun 2004;314:409–14
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed