Case report
Oncogenic osteomalacia associated with soft tissue chondromyxoid fibroma

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Abstract

Oncogenic osteomalacia is a rarely described clinical entity characterized by hypophosphatemia, phosphaturia, and a low concentration of 1,25-dihydroxyvitamin D3. It is most often associated with benign mesenchymal tumor and can be cured with surgical removal of the tumor. In this paper, we present a case of oncogenic osteomalacia caused by chondromyxoid fibroma in the soft tissue of the sole of the foot in a 56-year-old woman.

Introduction

Tumor-induced (oncogenic) osteomalacia is a rare clinicopathologic entity associated with unusual mostly mesenchymal tumors in which the clinical signs and symptoms of osteomalacia and the specific laboratory abnormalities of hypophosphatemia, hyperphosphaturia, and low serum levels of 1,25 dihydroxyvitamin D3 are associated [1], [2], [3], [4]. Surgical resection of this tumor can result in reversal of the osteomalacia and normalization of laboratory values.

We report a case of oncogenic osteomalacia associated with chondromyxoid fibroma in the soft tissue of the sole of the foot.

Section snippets

Case report

A 56-year-old woman presented with a 3-year history of diffuse, increasing bone pain and difficulty in walking. There was a more recent history of a protruding mass on the sole of the right foot increasing in size. Laboratory data showed a low serum phosphorus level (1.1 mg/dl; normal, 2.5–4.5), a normal serum calcium level (9 mg/dl; normal, 8.2–10.8), and an increased alkaline phosphatase (625 IU/l; normal, 96–254). Urinary excretion of phosphorus was high (392 mg/day), while the tubular

Discussion

Hypophosphatemic osteomalacia belongs to a heterogeneous group of disorders that can be associated with rare tumors arising from either soft tissues or bone. To date, less than 100 cases of oncogenic osteomalacia have been reported [1], [2], [3], [4]. They include hemangiopericytoma (the most common), bone and soft-tissue giant cell tumors, chondroblastoma, nonossifying and ossifying fibromas, fibroangioma, and mixed connective tissue variants tumor.

The clinical signs and symptoms of oncogenic

Acknowledgements

We thank Bonnie Hammi, Department of Radiology, University Hospitals of Cleveland, Cleveland, OH, for her editorial assistance in the preparation of the manuscript.

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