Open AccessA pathological hip fracture in an adult patient revealing oncogenic hypophosphemic osteomalacia secondary to bone fibrous dysplasia
Author(s) -
Adnane Boularouk,
Ras el Ehs Rééducation fonctionnelle,
Sarrah Aitziane,
Mahdi Guessas,
Smail Talbi,
Khaled Aboussetta
Publication year - 2014
Publication title -
batna journal of medical sciences
Language(s) - English
Resource type - Journals
ISSN - 2437-0665
DOI - 10.48087/bjmscr.2014.1216
Subject(s) - hypophosphatemia , osteomalacia , medicine , fibrous dysplasia , femoral neck , pathology , bone pain , dysplasia , osteoporosis
Oncogenic hypophosphatemic osteomalacia is a rare acquired condition (about 160 reported cases). The initial abnormality is the unregulated secretion of FGF-23 by small growth mesenchymal tumors. Fibrous dysplasia is a well-known cause of oncogenic osteomalacia, with the polyostotic form complicated in 50% of cases with severe hypophosphatemia. We report here the case of a 43 years-old man, admitted for diffuses bone pain and muscular proximal weakness, evolving for 2 years, complicated with a pathological femoral neck fracture. Lab studies found severe hypophosphatemia and an elevation of alkaline phosphatases with normal levels of serum calcium, 25OH-vit D3 and PTH. X-Rays revealed a diffuse bone demineralization with multiple vertebral fractures and a fracture of the femoral neck associated with multiple lytic lesions of the femoral diaphysis. Histological examination has concluded fibrous dysplasia. Main etiologies, such as iatrogenic causes and Fanconi syndrome, have not been considered. Treatment with phosphorus associated with 1,25OH-Vit D3 has been installed, associated with intravenous infusions of bisphosphonates.