Ovarian cancer-related hypophosphatemic osteomalacia - A case report
Journal
Journal of Clinical Endocrinology and Metabolism
Journal Volume
99
Journal Issue
12
Pages
4403-4407
Date Issued
2014
Author(s)
Abstract
Context: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused primarily by benign mesenchymal tumors. It has been associated with malignancies in rare cases. High serum levels of fibroblast growth factor (FGF) 23 reported in a group of patients with ovarian cancer had normal serum phosphate levels. There had been no ovarian cancer-related hypophosphatemic osteomalacia in a search of the literature. Objective: We investigated a 57-year-old woman with progressive low back pain. Design and Intervention: Clinical, biochemical, and radiological assessments were performed. The patient's serum phosphate and FGF23 levels were evaluated at baseline and after treatment for ovarian cancer. Results: The patient presented with progressive low back pain and weight loss during the previous 6 months. Imaging studies revealed low bone mineral density and multiple suspicious spinal metastatic lesions. Laboratory examination showed hypophosphatemia, hyperphosphaturia, normocalcemia, an elevated serum alkaline phosphatase level, and an elevated serum FGF23 level. Because TIO was suspected, a tumor survey was performed, and ovarian carcinoma with multiple metastasis was detected. After surgery and chemotherapy treatments for ovarian cancer, the serum phosphate and FGF23 levels returned to normal, and the low back pain improved. Conclusions: To our knowledge, this is the first case of ovarian cancer-related hypophosphatemic osteomalacia reported in the literature. TIO should be considered in patients with ovarian cancer presenting with weakness,bonepain,andfractures. Investigation of TIO is appropriatewhenthese patients present hypophosphatemia. ? 2014, Endocrine Society. All rights reserved.
SDGs
Other Subjects
alkaline phosphatase; calcium; carboplatin; fibroblast growth factor 23; paclitaxel; phosphate; tumor antigen; fibroblast growth factor; fibroblast growth factor 23; adjuvant therapy; adult; alkaline phosphatase blood level; appendectomy; Article; bone density; calcium blood level; case report; computer assisted tomography; female; human; hypophosphatemia; hysterectomy; low back pain; lymph node dissection; metastasis; middle aged; night sweat; omentectomy; oncogenic osteomalacia; ovary carcinoma; phosphate blood level; phosphaturia; salpingooophorectomy; spinal cord metastasis; weight reduction; blood; complication; hypophosphatemia; low back pain; multimodality cancer therapy; osteomalacia; Ovarian Neoplasms; Combined Modality Therapy; Female; Fibroblast Growth Factors; Humans; Hypophosphatemia; Low Back Pain; Middle Aged; Osteomalacia; Ovarian Neoplasms
Type
journal article