Chronic kidney failure mineral bone disorder leads to a permanent loss of hematopoietic stem cells through dysfunction of the stem cell niche.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declare no competing interests. 11. BMJ Case Rep. 2020 Dec 16;13(12):e238209. doi: 10.1136/bcr-2020-238209. Oncogenic osteomalacia due to phosphaturic mesenchymal tumour in the upper thoracic spine. Garg B(1), Mehta N(2), Goyal A(1), Khadgawat R(3). Author information: (1)Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India. (2)Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India mehta.nishank@gmail.com. (3)Endocrinology, All India Institute of Medical Sciences, New Delhi, India. Oncogenic osteomalacia (OO) is an uncommon paraneoplastic syndrome occurring due to the presence of a tumour that oversecretes fibroblast growth factor-23, which impairs renal phosphate handling. In most cases, the tumour is a morphologically distinct entity called 'phosphaturic mesenchymal tumour' (PMT). Spinal tumours causing OO are exceedingly rare. A 55-year-old man presented with multiple bone pain and proximal muscle weakness in the lower limbs. The constellation of biochemical findings (hypophosphataemia, normocalcaemia, increased alkaline phosphatase, low-normal serum vitamin D and hyperphosphaturia) with radiographical rarefaction of the skeleton and pseudofractures led us to consider OO as a possibility. Functional imaging (68Ga DOTA-NOC positron emission tomography/CT scan) localised the tumour to the D2 vertebra. Complete surgical resection led to resolution of symptoms, improved ambulatory status, normalisation of biochemical parameters and healing of pseudofractures. PMT should be considered in the differential diagnosis of hypophosphataemic osteomalacia with hyperphosphaturia. Tumour localisation with functional imaging and complete surgical resection produces satisfactory outcome. © BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ. DOI: 10.1136/bcr-2020-238209 PMCID: PMC7745698