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

摘要:

肿瘤相关性低磷骨软化症（tumor-inducedosteomalacia, 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（fibroblastgrowthfactor 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 basis of most TIO. PMT has abnormal oversecretion of fibroblast growth factor 23 (FGF-23), which leads abnormal depletion of kidney phosphate, 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 manifestations and treatment of this disease.