中年女性-全身骨痛-低磷血症  

Middle-aged female-generalized bone pain-hypophosphatemia

作　　者：魏祺 单慈 章振林[1] WEI Qi;SHAN Ci;ZHANG Zhen-lin(Department of Osteoporosis and Bone Disease,Shanghai Sixth People s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai Clinical Research Center of Bone Disease,Shanghai 200233,China;Department of Osteoporosis Clinical Center,The Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215000,China)

机构地区：[1]上海交通大学附属第六人民医院骨质疏松与骨病科,上海市骨疾病临床研究中心,上海200233 [2]苏州大学附属第二医院骨质疏松症临床中心,江苏苏州215000

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2024年第2期137-144,共8页Chinese Journal Of Osteoporosis And Bone Mineral Research

摘　　要：肿瘤性骨软化症(tumor-induced osteomalacia,TIO)为一种罕见的获得性代谢性骨病,TIO肿瘤常起病隐匿,瘤体较小,分布广泛,发生在颅内更为罕见。本文报告一位44岁女性患者,3年前出现双下肢疼痛、乏力,并逐渐全身骨痛、活动障碍、多处骨折,实验室检查提示低磷血症、碱性磷酸酶(alkaline phosphatase,ALP)高、成纤维细胞生长因子23(fibroblast growth factor-23,FGF-23)水平明显增高,考虑TIO。通过^(68)Ga-DOTATATE PET/CT全身成像发现大脑左侧额叶镰旁占位,并行头部MR进一步确认后,通过手术全切肿瘤,术后患者血磷逐渐恢复正常水平,FGF-23水平下降,全身骨痛消失,病理学检查证实肿瘤为磷酸盐尿性间叶性肿瘤(phosphaturic mesenchymal tumor,PMT)。Tumor-induced osteomalacia(TIO)is a rare acquired metabolic bone disease.TIO tumors are often occult,small and widely distributed and are even rare in the brain.This article reports a 44-year-old female patient who developed pain and weakness in lower limbs 3 years ago,and gradually developed systemic bone pain,mobility disorders,and multiple fractures.Laboratory examination indicated that hypophosphatemia and high alkaline phosphatase(ALP),and fibroblast growth factor-23(FGF-23)levels were significantly increased,and TIO was considered.^(68)Ga-DOTATATE PET/CT whole-body imaging revealed a space beside the left frontal lobe sickle of the brain.After further confirmation by MR of the head,total resection of the tumor was performed.After surgery,blood phosphorus gradually returned to normal level,FGF-23 level decreased,and systemic bone pain disappeared,and pathological examination confirmed that the tumor was phosphaturic mesenchymal tumor(PMT).

关 键 词：肿瘤骨软化症 低磷血症 颅内 成纤维细胞生长因子23 

分 类 号：R681[医药卫生—骨科学]