| 王晓阳,边家祥,黄文文,等.肿瘤相关性骨软化症 1例并文献复习[J].安徽医药,2025,29(12):2484-2487. |
| 肿瘤相关性骨软化症 1例并文献复习 |
| Tumor-associated osteomalacia:a case report and literature review |
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| DOI：10.3969/j.issn.1009-6469.2025.12.032 |
| 中文关键词: 骨软化症 低磷血症 肿瘤，继发原发性 磷酸盐尿性间叶性肿瘤 成纤维细胞生长因子 23 骨质疏松 |
| 英文关键词: Osteomalacia Hypophosphatemia Neoplasms, second primary Phosphaturic mesenchymal tumor Fibroblast growth factor 23 Osteoporosis |
| 基金项目: |
| 作者 | 单位 | E-mail | | 王晓阳 | 山东第二医科大学临床医学院,山东 潍坊 261042 | | | 边家祥 | 山东第二医科大学临床医学院,山东 潍坊 261042 | | | 黄文文 | 潍坊市人民医院,内分泌科,山东潍坊 261041 | | | 宋立稳 | 潍坊市人民医院,内分泌科,山东潍坊 261041 | | | 刘海霞 | 潍坊市人民医院,内分泌科,山东潍坊 261041 | | | 程丽霞 | 潍坊市人民医院,健康管理中心,山东潍坊 261041 | wfnfmclx@163.com |
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| 中文摘要: |
| 目的报告 1例肿瘤相关性骨软化症( TIO)提高临床医师对本病的认识，减少误诊。方法回顾性分析潍坊市人民医院 2023年 8月 2日收治的 1例 TIO病人的临床资料，并，复习相关文献。结果男， 56岁，“全身骨痛 7年余，双髋疼痛加重 10余天”收入院。入院后根据低血清磷、高尿磷、高碱性磷酸酶( ALP)、高成纤维细胞生长因子因23(FGF-23)水平和 X线提示假骨折线、奥曲肽显像等检查考虑磷酸盐尿性间叶性肿瘤(PMT)引起的 TIO。遂行颅底肿瘤切除联合口服碳酸钙 D3片、骨化三醇、维生素 D滴剂、中性磷溶液治疗，复查血清磷较前上升，双髋关节疼痛基本缓解出院。病人半月后复查血清磷在正常范围，已能扶拐行走，双髋关节无明显疼痛。结论接诊成年起病、无家族史、有乏力、骨痛、骨折、骨骼畸形等临床表现的病人，伴血磷下降、尿磷上升、肾磷域下降、血 FGF-23水平升高、血 ALP水平升高、假骨折线形成要考虑到 TIO可能，积极完善相关检查，减少误诊。 |
| 英文摘要: |
| Objective To report a case of tumor-induced osteomalacia (TIO) in order to improve the understanding of the disease and reduce misdiagnosis.Methods A retrospective analysis was made of the clinical data of one TIO patient admitted to Weifang People'sHospital on August 2, 2023, and the relevant literature was reviewed.Results A 56-year-old male was admitted to the hospital with"generalized bone pain for more than 7 years and aggravated hip pain for more than 10 days". After admission, TIO caused by phospha-turic mesenchymal tumor (PMT) was considered based on low serum phosphorus, high urine phosphorus, high alkaline phosphatase(ALP), high fibroblast growth factor 23 (FGF-23) levels, X-ray pseudofracture line, and octreotide scintigraphy. Then, skull base tumorresection combined with oral calcium carbonate D3 tablets, calcitriol, vitamin D drops, and neutral phosphorus solution were treated,and the serum phosphorus increased after reexamination, and the pain in both hip joints was basically relieved and discharged. Half amonth later, the patient's serum phosphorus was in the normal range, and he was able to walk on crutches, and there was no obviouspain in both hip joints.Conclusion In the treatment of patients with adult onset of illness, no family history, fatigue, bone pain, frac-ture, skeletal deformity and other clinical manifestations, with decreased blood phosphorus, increased urine phosphorus, decreased re-nal phosphorus domain, increased blood FGF-23 level, increased blood alkaline phosphatase (ALP) level, and pseudofracture line for-mation, the possibility of TIO should be considered, and relevant examinations should be actively improved to reduce misdiagnosis. |
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