Tumor-Induced Hypophosphatemic Osteomalacia Diagnosed by the Combinatory Procedures of Magnetic Resonance Imaging and Venous Sampling for FGF23

Tetsushi Nasu; Seigo Kurisu; Shohei Matsuno; Kunihiro Tatsumi; Tetsuhiro Kakimoto; Masato Kobayashi; Yoshio Nakano; Hisao Wakasaki; Hiroto Furuta; Masahiro Nishi; Hideyuki Sasaki; Hisanori Suzuki; Nobuaki Ito; Seiji Fukumoto; Kishio Nanjo

doi:10.2169/internalmedicine.47.0745

CASE REPORTS

Tumor-Induced Hypophosphatemic Osteomalacia Diagnosed by the Combinatory Procedures of Magnetic Resonance Imaging and Venous Sampling for FGF23

Tetsushi Nasu, Seigo Kurisu, Shohei Matsuno, Kunihiro Tatsumi, Tetsuhiro Kakimoto, Masato Kobayashi, Yoshio Nakano, Hisao Wakasaki, Hiroto Furuta, Masahiro Nishi, Hideyuki Sasaki, Hisanori Suzuki, Nobuaki Ito, Seiji Fukumoto, Kishio Nanjo

Author information

Tetsushi Nasu
The First Department of Medicine, Wakayama Medical University
Seigo Kurisu
The First Department of Medicine, Wakayama Medical University
Shohei Matsuno
The First Department of Medicine, Wakayama Medical University
Kunihiro Tatsumi
The First Department of Medicine, Wakayama Medical University
Tetsuhiro Kakimoto
The First Department of Medicine, Wakayama Medical University
Masato Kobayashi
The First Department of Medicine, Wakayama Medical University
Yoshio Nakano
The First Department of Medicine, Wakayama Medical University
Hisao Wakasaki
The First Department of Medicine, Wakayama Medical University
Hiroto Furuta
The First Department of Medicine, Wakayama Medical University
Masahiro Nishi
The First Department of Medicine, Wakayama Medical University
Hideyuki Sasaki
The First Department of Medicine, Wakayama Medical University
Hisanori Suzuki
Division of Nephrology and Endocrinology, Department of Internal Medicine, University of Tokyo
Nobuaki Ito
Division of Nephrology and Endocrinology, Department of Internal Medicine, University of Tokyo
Seiji Fukumoto
Division of Nephrology and Endocrinology, Department of Internal Medicine, University of Tokyo
Kishio Nanjo
The First Department of Medicine, Wakayama Medical University

Keywords: tumor-induced osteomalacia, MRI, FGF23, venous sampling

JOURNAL OPEN ACCESS

2008 Volume 47 Issue 10 Pages 957-961

DOI https://doi.org/10.2169/internalmedicine.47.0745

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Abstract

This report describes a 37-year-old man with tumor-induced osteomalacia (TIO). The patient had hypophosphatemia and elevated fibroblast growth factor 23 (FGF23) in the peripheral blood. Magnetic resonance imaging detected an abnormal mass in the left greater trochanter. Venous sampling revealed a significantly higher level of FGF23 in the left common iliac vein (proximal to the tumor), verifying that the tumor is responsible for TIO. The serum level of FGF23 decreased and symptoms improved after removal of the tumor. The combined diagnostic procedures of MRI and venous sampling for FGF23 effectively detected the tumor responsible for TIO.

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