Osteomalacia-Inducing Tumors of the Brain: A Case Report, Review and a Hypothesis

World Neurosurgery
Hussein FathallaKalman Kovacs

Abstract

Osteomalacia-inducing tumors (OIT) are mesenchymal tumors that characteristically secrete fibroblast growth factor 23, resulting in a paraneoplastic syndrome of hypophosphatemic osteomalacia. These tumors are known to occur in soft tissues and bones in various sites. It is very unusual for OITs to occur intracranially, with only 10 reported intracranial cases since their discovery in 1959. The most common intracrainal OITs are phosphaturic mesenchymal tumors and hemangiopericytomas. We report a case of hypophosphatemic osteomalacia caused by a tumor in the right anterior cranial fossa. We also hypothesize, based on our review of the literature, that this entity is underdiagnosed. A 49-year-old woman had a history of a nonhealing ankle fracture that required repeated surgery over 3 years. She subsequently was found to have severe hypophosphatemia and evidence of osteomalacia together with multiple occult fractures. A diagnosis of tumor-induced osteomalacia was suspected. An elevated serum fibroblast growth factor 23 level confirmed the diagnosis. An octreotide scan that was performed to locate the responsible tumor revealed an area of avid uptake in the right frontal lobe. Magnetic resonance imaging showed a large right anterior...Continue Reading

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Citations

Jan 1, 2016·Endocrinología y nutrición : órgano de la Sociedad Española de Endocrinología y Nutrición·Guillermo Alonso, Mariela Varsavsky
Jul 2, 2019·Advances in Anatomic Pathology·Michele BiscegliaAlfredo Scillitani
Sep 13, 2018·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Huanwen WuDingrong Zhong
Jun 20, 2018·Bone·M C VlotA C Heijboer

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