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Endocrine Abstracts (2014) 35 P151 | DOI: 10.1530/endoabs.35.P151

Endocrinology and Metabolism Department, Faculty of Medicine, Gazi University, Ankara, Turkey.

Introduction: Oncogenic osteomalasia is a rare paraneoplastic syndrome in which a tumor produces fibroblast growth factor 23 which leads to increased urinary phosphate excretion resulting in hypophosphatemia. It is frequently associated with mesenchymal tumors of bone and soft tissues. We report a case of oncogenic osteomalasia due to lipoma.

Case report: A 38-year-old female patient with a 6-year history of left hip pain which progressively worsened over years. Owing to the pain and muscle weakness especially in her lower extremities she gradually became unable to walk. When she was admitted to our clinic she had severe diffuse muscle pain, she was bed-ridden, she was unable to walk. Physical examination revealed 2 cm subcutaneous, dome-shaped, smooth, mobile noduler lesion on abdomen below umblicus. Laboratory testing was remarkable for low serum phosphorus, increased urinary phosphate excretion, elevated serum FGF23 level, normal calcitriol which was consistent with oncogenic osteomalasia. Excisional biopsy was performed for lesions described on abdomen. Pathological examination of lesion on abdomen reported as lipoma. Phosphate levels gradually increased and returned to normal 5 days after excision of lesions. Muscle weakness gradually improved on folllow-up visits, she became able to walk without support. She is being followed-up in our clinic with normal phospfate levels and she is clinically well.

Conclusion: Oncogenic osteomalasia is an important cause of hypophosphatemia which may be debilitating for the patient. Our case is a very rare case of oncogenic osteomalasia due to lipoma.

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