Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Detection of the primary tumor site in tumor-induced osteomalacia by indium-111 octreotide scintigraphy: A case report

Makoto Takahashi, M.D.1), Syuta Toru, M.D.1), Kiyohumi Ota, M.D.1), Hajime Izumiyama, M.D.2), Takanori Yokota, M.D.1) and Hidehiro Mizusawa, M.D.1)

1)Department of Neurology and Neurological Science, Graduate School, Tokyo Medical and Dental University
2)Department of Clinical and Molecular Endocrinology, Graduate School, Tokyo Medical and Dental University

We report a 31-year-old woman with tumor-induced osteomalacia suffering from slowly progressive bilateral muscle weakness predominantly in the proximal muscles and multiple bone pains for the past 2 years. She was unable to walk or raise her arms above the shoulder. We suspected tumor-induced osteomalacia due to decreased serum phosphate and 1α, 25 (OH)2-vitamin D3 levels, low percentage of tubular reabsorption of phosphate (%TRP), adult onset, and no family history of osteomalacia. Regular imaging examinations could not detect the location of the primary tumor; however, indium-111 octreotide scintigraphy detected the causative primary mesenchymal tumor in the right sole. Pain and muscle weakness improved promptly after tumor resection, and she was able to walk 6 d postoperatively. This is the first case report in Japan describing the detection of the primary tumor site by indium-111 octreotide scintigraphy.
Full Text of this Article in Japanese PDF (426K)

(CLINICA NEUROL, 48: 120|124, 2008)
key words: tumor induced osteomalacic myopathy, octreotide scintigraphy, Fibroblast growth factor 23 (FGF23), paraneoplastic syndrome, hypophosphatemia

(Received: 6-Jun-07)