Oncogenic osteomalacia

Oncogenic osteomalacia is a rare paraneoplastic syndrome, or a disease or symptom that is the consequence of cancer in the body but, unlike mass effect, is not due to the local presence of cancer cells. This condition is associated with benign mesenchymal tumors. These tumors produce excessive amounts of a protein known as fibroblast growth factor 23 (FGF23), which plays a key role in the regulation of phosphate metabolism.

Symptoms

The symptoms of oncogenic osteomalacia can vary greatly from person to person. However, some common symptoms include bone pain, muscle weakness, and fractures. These symptoms are often the result of low levels of phosphate in the blood, a condition known as hypophosphatemia.

Causes

Oncogenic osteomalacia is caused by tumors that produce excessive amounts of FGF23. This protein regulates phosphate metabolism by reducing the reabsorption of phosphate by the kidneys, leading to phosphate wasting and hypophosphatemia. The tumors can be located anywhere in the body, but are most commonly found in the bones, skin, and soft tissues.

Diagnosis

Diagnosis of oncogenic osteomalacia can be challenging due to the rarity of the condition and the often small size and unusual locations of the tumors. However, it typically involves blood tests to measure levels of phosphate and FGF23, as well as imaging studies to locate the tumor.

Treatment

Treatment of oncogenic osteomalacia involves removing the tumor, which usually leads to a resolution of the symptoms. In cases where the tumor cannot be located or removed, treatment may involve supplements to increase phosphate levels and medications to reduce the production of FGF23.

See also

• Paraneoplastic syndromes
• Fibroblast growth factor 23
• Phosphate metabolism
• Hypophosphatemia

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