肿瘤相关性骨软化症3例分析并文献复习  

Tumor-induced osteomalacia:a report of 3 cases and reviewof literature

作　　者：蒋洁[1] 张晓黎[1] 董明[1] 刘金波[1] 蒋玲[1] 

机构地区：[1]山东大学齐鲁医院内分泌科,山东济南250012

出　　处：《山东大学学报（医学版）》2017年第5期108-111,116,共5页Journal of Shandong University:Health Sciences

摘　　要：目的探讨肿瘤相关性骨软化症(TIO)并进行相关文献复习。方法选取2015年6月至2016年2月收治的3例TIO患者临床资料,随访至2016年10月,并行相关文献复习。结果 3例均表现为进行性加重骨痛、肌痛。3例均显示低血磷、高尿磷以及碱性磷酸酶升高,影像学检查示骨软化。2例查见体表肿物,1例查见牙龈肿物,3例均行诊断性治疗手术切除肿物,病理为磷酸盐尿性间叶肿瘤(PMT),诊断为TIO。术后随访生化指标及临床症状均明显改善。结论 TIO是一种罕见的副肿瘤综合征,一般生长缓慢且位置隐匿,临床易误诊或漏诊,但手术切除肿瘤后,患者预后良好。由此可见,临床及时发现肿瘤非常重要。Objective To explore tumor-induced osteomalacia （TIO） and review relevant literature. Methods The clinical information of 3 TIO cases treated in our hospital in Feb. 2016 were retrospectively analyzed and relevant litera- tures were retrieved. Result All 3 cases manifested progressive ostalgia and myalgia. The laboratory readings indicated hypophosphatemia, hyperphosphaturia and elevated alkaline phosphatase. Imaging examinations showed osteomalacia. Masses on the body surface were observed in 2 cases, and a mass on the gum was detected in 1 case. All masses were removed, and the postoperative pathological results were phosphaturic mesenchymal tumor. The follow-up showed im- provements of biochemical indexes and clinical symptoms. Conclusion TIO is a rare paraneoplastic syndrome. As tumors usually grow slowly and are not easy to be observed, they are likely to be misdiagnosed or underdiagnosed. However, resection of tumors shows good prognosis. Therefore, it is very important to find the tumors promptly.

关 键 词：肿瘤相关性骨软化症 低血磷 高尿磷 手术治疗 

分 类 号：R589[医药卫生—内分泌]