鼻腔肿瘤相关低磷骨性软化症1例报告及文献复习

Hypophosphatemic osteomalacia caused by nasal cavity tumor:A case report and literature review

目的了解肿瘤相关性低磷骨软化症(TIO)临床及病例特点,提高诊断治疗水平。方法对1例TIO临床资料进行回顾性分析,并复习相关文献。结果患者表现为进行性加重的全身骨痛、病理性骨折、血磷减少、尿磷增高,骨质疏松,入院后经鼻窦CT检查诊断左侧鼻腔内血管瘤可能性大,手术切除肿瘤病理报告证实为血管球周皮细胞瘤,术后3天复查血磷开始升高,尿磷下降,术后1个月血磷正常,患者全身疼痛改善,双下肢乏力缓解,活动恢复正常,术后6个月骨密度恢复正常。结论对表现为乏力、骨痛、低血磷、高尿磷,骨质疏松或多发性骨折患者,体格检查或影像学检查提示有占位或肿瘤时,应首先考虑TIO。

Objective To study the clinical features of tumor-induced osteomalacia（ TIO）,in order to improve the diagnosis and treatment level of this disease. Methods The clinical data of one patient with TIO were retrospectively analyzed,and the relevant literatures were reviewed. Results The patient appeared progressive and whole body bone pain, pathological fracture,hypophosphatemia,hyperphosphaturia,and osteoporosis. Left nasal hemangioma was found by paranasal sinus CT scan. Resection was performed and then glomangiopericy tumor was pathologically confirmed. The serum phosphorus concentration gradually increased and urinary phosphorus decreased after tumor resection in 3 days. Serum phosphorus was back to normal in 1 month. Bone pain and lower limb weakness were alleviated. Moving ability restored and bone mineral density backed to normal in 6 months.Conclusion When patients complain of weakness,bone pain,hypophosphatemia,hyperphosphaturia,osteoporosis or multiple fractures,and physical examination or imaging examination suggests mass lesions or tumors,TIO should be first considered.