Tumor induced osteomalacia from a peripheral mesenchymal tumour of the foot

Andrew Strydom; Wessel Greeff; Paulo N F Ferrao; Nikiforos P Saragas

doi:10.1016/j.foot.2023.101979

Tumor induced osteomalacia from a peripheral mesenchymal tumour of the foot

Foot (Edinb). 2023 May:55:101979. doi: 10.1016/j.foot.2023.101979. Epub 2023 Feb 19.

Authors

Andrew Strydom¹, Wessel Greeff², Paulo N F Ferrao³, Nikiforos P Saragas⁴

Affiliations

¹ Consultant Foot and Ankle Surgeon, Suite 3A, -2 Level, Westwing, Netcare Sunninghill Hospital, Cnr Nanyuki & Witkoppen Road, Sunninghill, 2157, South Africa. Electronic address: drewstrydom@hotmail.com.
² Orthopaedic Surgeon, Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), University of the Witwatersrand, Division of Orthopaedic Surgery, South Africa. Electronic address: tingreeff@gmail.com.
³ Orthopaedic Surgeon, Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), University of the Witwatersrand, Division of Orthopaedic Surgery, South Africa; Consultant Foot and Ankle Surgeon, The Orthopaedic Foot and Ankle Unit, Suite 303 Netcare Linksfield Park Clinic, 24 12th Avenue, Orange Grove, 2192, South Africa. Electronic address: paulo@cybersmart.co.za.
⁴ Adjunct Professor, University of the Witwatersrand, Division of Orthopaedic Surgery, South Africa; Consultant Foot and Ankle Surgeon, The Orthopaedic Foot and Ankle Unit, Suite 303 Netcare Linksfield Park Clinic, 24 12th Avenue, Orange Grove, 2192, South Africa. Electronic address: saragas@global.co.za.

PMID: 36871520
DOI: 10.1016/j.foot.2023.101979

Abstract

Tumour induced osteomalacia (TIO) is a rare condition caused by peripheral mesenchymal tumours (PMT) which produce fibroblast-growth factor 23 (FGF23). FGF23 inhibits renal phosphate reabsorption leading to vitamin D resistant osteomalacia. The rarity of the condition and difficulty with isolating the PMT make diagnosis difficult, with delayed treatment leading to significant patient morbidity. We present a case of PMT of the foot with TIO, with a discussion on diagnosis and treatment.

Keywords: Hypophosphatemic osteomalcia; Pathological fractures; Peripheral mesenchymal tumour; Tumor induced osteomalacia.

Publication types

Case Reports

MeSH terms

Fibroblast Growth Factors
Humans
Osteomalacia* / diagnosis
Osteomalacia* / etiology
Osteomalacia* / pathology
Paraneoplastic Syndromes* / diagnosis
Paraneoplastic Syndromes* / etiology
Paraneoplastic Syndromes* / pathology
Phosphates

Substances

Fibroblast Growth Factors
Phosphates

Supplementary concepts

Oncogenic osteomalacia