肿瘤相关低磷骨软化症掌骨溶解:1例报告和综述
Metacarpal osteolysis in tumor-induced osteomalacia:a case report and literature review
黄川洪 1陈跃平 1董盼锋 1陈尚桐1
作者信息
- 1. 广西中医药大学附属瑞康医院创伤骨科及手外科,广西南宁 530011
- 折叠
摘要
肿瘤相关性低磷骨软化症(tumor-induced osteomalacia,TIO)是一种罕见疾病,磷酸盐尿间质肿瘤(phosphaturic mesenchymal tumor,PMT)是大多数TIO患者的病理基础,PMT会异常过量分泌成纤维细胞生长因子23(fibroblast growth factor 23,FGF-23),导致肾脏磷酸盐异常消耗,引发血磷下降、四肢无力、骨骼肌肉疼痛等症状.通过手术切除肿瘤可以根治TIO,但其肿瘤往往体积小、位置隐匿,因而诊治困难.作者团队于2021年通过手术方法治疗了 1例肿瘤直接侵蚀导致第3掌骨完全溶解的患者,术后进行了 28个月的随访,最终获得痊愈.现进行报道并对相关文献进行回顾,总结该疾病的发病机理与特点、临床表现及治疗方案.
Abstract
Tumor-induced osteomalacia(TIO)is a rare disease and the phosphaturic mesenchymal tumor(PMT)is the pathological ba-sis of most TIO.PMT has abnormal oversecretion of fibroblast growth factor 23(FGF-23),which leads abnormal depletion of kidney phos-phate,decline of blood phosphorus,limb weakness,skeletal muscle pain and other symptoms.TIO can be cured by surgical resection of the tumor,but the tumor is often small in size and hidden in location,which makes diagnosis and treatment difficult.In 2021,the author's team surgically treated a patient who had complete osteolysis of the third metacarpal bone caused by direct tumor erosion,and finally recovered 28 months after surgery.This paper reports and reviews relevant literature to summarize the pathogenesis,characteristics,clinical manifesta-tions and treatment of this disease.
关键词
肿瘤相关性骨软化症/骨溶解/成纤维细胞生长因子23/磷酸盐尿间质肿瘤Key words
tumor-induced osteomalacia/osteolysis/fibroblast growth factor 23/phosphaturic mesenchymal tumor引用本文复制引用
出版年
2024
NETL
NSTL
万方数据