Advanced prostate cancer as a cause of oncogenic osteomalacia: an underdiagnosed condition

Support Care Cancer. 2012 Sep;20(9):2195-7. doi: 10.1007/s00520-012-1474-z. Epub 2012 May 4.

Abstract

Purpose: Tumor-induced osteomalacia (TIO) is a paraneoplastic bone mineral disturbance related to fibroblast growth factor 23 (FGF23) overproduction by the tumor, usually from mesenchymal origin. Such condition leads to high phosphate renal wasting and, consequently, to cumbersome symptoms as weakness, bone pain, and fractures.

Method: Case report.

Result: We report a case of an advanced castration-refractory prostate cancer patient, which developed severe hypophosphatemia with elevated phosphate excretion fraction. TIO was suspected, and increased levels of FGF23 reinforced such diagnosis. The patient died 4 months after being diagnosed with TIO.

Conclusion: This case suggests that TIO has a dismal prognosis in prostate cancer patients. The clinical oncology community must be aware about such disturbance that can be present in those patients with weakness, bone pain, and hypophosphatemia.

Publication types

  • Case Reports

MeSH terms

  • Brazil
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / blood
  • Humans
  • Hypophosphatemia / blood
  • Male
  • Middle Aged
  • Neoplasms, Connective Tissue / diagnosis
  • Neoplasms, Connective Tissue / etiology*
  • Neoplasms, Connective Tissue / secondary*
  • Osteomalacia
  • Paraneoplastic Syndromes
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / complications*
  • Prostatic Neoplasms / pathology

Substances

  • FGF23 protein, human
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23

Supplementary concepts

  • Oncogenic osteomalacia