Case reportOncogenic osteomalacia associated with soft tissue chondromyxoid fibroma
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.
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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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Nodular lesion in the buccal mucosa
2015, Journal of the American Dental AssociationCitation Excerpt :Investigators have reported the extension of the tumor to soft tissue.25 However, to the best of our knowledge, investigators have described only 2 cases of a primary tumor with no bone involvement.25,26 In the histologic analysis, soft-tissue chondromyxoid fibroma exhibits a lobular pattern with stellate or spindle-shaped cells on a myxoid or chondroid background.
Benign cartilage tumors
2014, Diagnostic HistopathologyCitation Excerpt :Rarely, it can present as a surface lesion.19–25 Similar to chondroblastomas the paraneoplastic syndrome of oncogenic osteomalacia has been associated with chondromyxoid fibroma1,26,27 and FGF 23 has been identified on some tumors.2 Radiological features: radiographically, the tumors are metaphyseal, eccentric and sharply delineated (Figure 4).
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