What is it about?
Generally tumor induced osteomalacia(a disease of the where bones are not adequately mineralized) is caused by a single well defined tumor. These tumors produce substances called phosphatonins which cause phosphate leak in the urine. Since the bone is made up of calcium and phosphate, loss of one of the building blocks leads to deficient mineralization. In this paper, we show for the first time, that these tumors can be multiple.
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Why is it important?
If a patient of tumor induced osteomalacia doesn't improve after removing the putative tumor , one should consider the possibility of second tumor.
Perspectives
If there's no significant rise in phosphate levels after surgery, it is best to measure Fibroblast growth factor 23 levels again. While there are no well defined normal values for FGF 23, the presence of even "normal" levels is abnormal in the setting of low serum phosphate. This should trigger a search for another tumor.
Dr Karthik Balachandran
Read the Original
This page is a summary of: Tumor(s) Induced Osteomalacia—A Curious Case of Double Trouble, The Journal of Clinical Endocrinology & Metabolism, February 2014, Endocrine Society,
DOI: 10.1210/jc.2013-3791.
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