Tumor-induced Osteomalacia Successfully Treated by En Bloc Tumor Excision and Reconstruction Using a Tumor-bearing Frozen Autograft : A Case Report

Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved..

BACKGROUND/AIM: Tumor-induced osteomalacia (TIO) is a rare pathology caused by overproduction of fibroblast growth factor 23 (FGF23). Its common clinical features include generalized muscle weakness, bone pain, and fractures. Complete resection of the offending tumor is the mainstay treatment. In this report, we present the first case of TIO by an FGF23 producing tumor treated using a tumor-bearing autograft treated with liquid nitrogen.

CASE REPORT: A 63-year old female presented with generalized body pain, particularly in the left arm. The patient was diagnosed with a FGF23 producing tumor of the left humerus. Wide resection of the involved tumor was performed using a tumor-bearing autograft that was treated with liquid nitrogen. Postoperatively, the FGF23 and alkaline phosphatase (ALP) levels significantly decreased and inorganic phosphate normalized. There was also subsequent relief of generalized body pain. Immediately after the operation, range of motion of the left shoulder and elbow was initiated. The patient was instructed to perform forward flexion and abduction up to 90° with a rotational restraint. Almost complete bone union was observed at 12 months post procedure. Postoperative functional results were as follows: Musculoskeletal Tumor Society (MSTS) score of 27/30, 90% and International Society of Limb Salvage (ISOLS) score of 26/30, 87%. Ten years after the surgery, osteotomy line was completely obscured based on radiographs. The patient was disease free and without activity limitation.

CONCLUSION: This is the first case report of wide excision of a FGF23 producing tumor and reconstruction using a tumor-bearing frozen autograft performed with excellent outcomes.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:44

Enthalten in:

Anticancer research - 44(2024), 4 vom: 27. März, Seite 1791-1797

Sprache:

Englisch

Beteiligte Personen:

Bangcoy, Martin Louie S [VerfasserIn]
Miwa, Shinji [VerfasserIn]
Yamamoto, Norio [VerfasserIn]
Hayashi, Katsuhiro [VerfasserIn]
Nishida, Hideji [VerfasserIn]
Takeuchi, Akihiko [VerfasserIn]
Igarashi, Kentaro [VerfasserIn]
Kato, Takashi [VerfasserIn]
Taniguchi, Yuta [VerfasserIn]
Morinaga, Sei [VerfasserIn]
Asano, Yohei [VerfasserIn]
Tsuchiya, Hiroyuki [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
FGF23 producing tumor
Frozen autograft
Journal Article
Liquid nitrogen
N762921K75
Nitrogen
Tumor-induced osteomalacia

Anmerkungen:

Date Completed 29.03.2024

Date Revised 29.03.2024

published: Print

Citation Status MEDLINE

doi:

10.21873/anticanres.16979

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370274997