Case Report
Copyright ©2013 Baishideng. All rights reserved.
World J Clin Cases. Apr 16, 2013; 1(1): 59-63
Published online Apr 16, 2013. doi: 10.12998/wjcc.v1.i1.59
Tumour induced osteomalacia due to a sinonasal hemangiopericytoma: A case report
Sophie A Jamal, Brendan C Dickson, Ina Radziunas
Sophie A Jamal, Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, ON M5G 1N8, Canada
Brendan C Dickson, Department of Pathology, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
Ina Radziunas, Multidisciplinary Osteoporosis Program, Women’s College Hospital, Toronto, ON M5S 1B1, Canada
Author contributions: All authors contributed to the manuscript writing and revision.
Correspondence to: Dr. Sophie A Jamal, Associate Professor of Medicine, Division of Endocrinology, Department of Medicine, University of Toronto, 790 Bay Street, 7th Floor, Toronto, ON M5G 1N8, Canada. sophie.jamal@utoronto.ca
Telephone: +1-416-3236400 Fax: +1-416-3513746
Received: November 5, 2012
Revised: January 5, 2013
Accepted: March 8, 2013
Published online: April 16, 2013
Abstract

Tumour induced osteomalacia (TIO) is a rare and often unrecognized cause of hypophosphatemia. We report on a case of TIO due to a hemangiopericytoma originating from the left nasal sinus. The patient was a 55-year-old male with a 3-year history of left hip pain and an undisplaced left hip fracture. Biochemical testing demonstrated low levels of serum phosphate and serum 1,25-dihydroxyvitamin D, and an elevated level of fibroblast growth factor 23. Octreotide scanning demonstrated uptake in the left nasal sinus area and a computed tomography scan revealed a left nasal sinus mass. The patient underwent surgical resection of the mass and histology was consistent with a sinonasal hemangiopericytoma. His serum phosphate levels normalized almost immediately after surgery and he had complete resolution of hip pain. Our case highlights the importance of considering TIO when assessing patients with low serum phosphate.

Keywords: Phosphate, Osteomalacia, Tumour, Fibroblast growth factor 23

Core tip: Tumour induced osteomalacia (TIO) is a rare and often unrecognized cause of hypophosphatemia. We report on a case of TIO due to a hemangiopericytoma originating from the left nasal sinus. The patient was a 55-year-old male with a 3-year history of left hip pain and an undisplaced left hip fracture. Our case highlights the importance of considering TIO when assessing patients with low serum phosphate.