Glomus Tumor ; diagnosis ; etiology ; Humans ; Neoplasms, Connective Tissue ; complications ; Osteomalacia

Humans ; Hypophosphatemia ; blood ; complications ; Neoplasms ; blood ; complications ; Osteomalacia ; blood ; diagnosis ; drug therapy ; etiology ; surgery ; Phosphates ; blood

Adult ; Diagnostic Errors ; Humans ; Hypophosphatemia ; diagnosis ; etiology ; therapy ; Male ; Middle Aged ; Neoplasms ; complications ; Osteomalacia ; diagnosis ; etiology ; therapy ; Young Adult

Oncogenic osteomalacia is an unusual and rare clinicopathologic syndrome characterized by mesenchymal tumors that apparently produce osteomalacia and biochemical abnormalities consisting of hypophosphatemia, normocalcemia, and increased levels of alkaline phosphatase. We collected from the Mayo Clinic files and from our consultation files the records for 17 cases of osteomalacia associated with bone lesions. There were five cases of fibrous dysplasia, three of hemangiopericytoma, and two of phosphaturic mesenchymal tumor. There was one case each of osteosarcoma, chondroblastoma, chondromyxoid fibroma, malignant fibrous histiocytoma, giant cell tumor, metaphyseal fibrous defect, and hemangioma. In this study we can figure out that the most common characteristic histologic features of our cases were hemangiopericytomatous vascular proliferation, fine lace-like stromal calcification, and stromal giant cells. In most of the cases, the clinical and biochemical symptoms and signs resolved soon after complete resection of the lesion. When the lesion recurred or metastasized, the symptoms and signs also recurred.
Adolescent ; Adult ; Aged ; Bone Neoplasms/classification/*complications/diagnosis ; Child ; Child, Preschool ; Female ; Fibrous Dysplasia of Bone/classification/*complications/diagnosis ; Follow-Up Studies ; Human ; Male ; Middle Age ; Osteomalacia/*etiology/pathology

Actins ; metabolism ; Bone Neoplasms ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Hypophosphatemia ; blood ; etiology ; Ilium ; Mesenchymoma ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Middle Aged ; Osteomalacia ; blood ; etiology ; Phosphates ; blood ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Tomography, X-Ray Computed

Adefovir dipivoxil, an acyclic nucleoside analogue, has been approved for the treatment of patients with chronic hepatitis B. This agent is efficacious particularly in those who have developed lamivudine resistance. The report according to hypophosphatemia induced by low dose adefovir therapy is very rare. We report one case in which osteomalacia with hypophosphatemia developed in a patient with chronic hepatitis B on adefovir dipivoxil at a low dose, 10 mg daily. A 66-year-old man, who had been taking adefovir for more than 4 years due to lamivudine resistance, presented with muscle weakness and bone pain in both thighs. After 3 years of adefovir therapy, hypophosphatemia and elevated serum alkaline phosphatase levels had been noted. A bone scan showed multiple hot uptakes. All the image findings and clinical symptoms, such as bone pain and muscle weakness were improved after correcting the hypophosphatemia with oral phosphorous supplementation.
Adenine/adverse effects/*analogs & derivatives/therapeutic use ; Aged ; Alkaline Phosphatase/blood ; Antiviral Agents/*adverse effects/therapeutic use ; DNA, Viral/blood ; Dietary Supplements ; Hepatitis B, Chronic/*drug therapy ; Humans ; Hypophosphatemia/*chemically induced/complications ; Liver Cirrhosis/diagnosis ; Male ; Osteomalacia/*diagnosis/etiology ; Phosphates/blood ; Phosphonic Acids/*adverse effects/therapeutic use ; Whole Body Imaging