{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T14:47:53Z","timestamp":1766760473838},"reference-count":16,"publisher":"The Endocrine Society","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,11,1]]},"abstract":"\n Context:<\/jats:title>\n Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome, characterized by tumor secretion of fibroblast growth factor-23 (FGF23) causing hypophosphatemia due to renal phosphate wasting. TIO is usually caused by small, benign, difficult-to-localize, mesenchymal tumors. Although surgery with wide excision of tumor borders is considered the \u201cgold standard\u201d for definitive therapy, it can be associated with considerable morbidity depending on the location. To date, radiation therapy has not been considered as an effective treatment modality in TIO.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n A 67-year-old female presented with multiple nontraumatic fractures, progressive bone pain, and muscle weakness for 4 years. She was found to have biochemical evidence of urinary phosphate wasting with low serum phosphorus, low-normal serum calcium, normal 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D, and high serum FGF23 levels. TIO was diagnosed. Selective venous sampling for FGF23 confirmed that a 1.7-cm left frontal mass, radiographically similar to a meningioma, was the causative tumor. She declined surgery due to fear of complications and instead underwent fractionated stereotactic radiotherapy for 6 weeks.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n In less than 4 years after radiation therapy, she was successfully weaned off phosphorus and calcitriol, starting from 2 g of oral phosphorus daily and 1 \u03bcg of calcitriol daily. Her symptoms have resolved, and she has not had any new fractures.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Stereotactic radiotherapy was an effective treatment modality for TIO in our patient. Fractionated stereotactic radiation therapy represents an alternative to surgery for patients with TIO who are not surgical candidates or who decline surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1210\/jc.2013-2528","type":"journal-article","created":{"date-parts":[[2013,9,7]],"date-time":"2013-09-07T02:43:35Z","timestamp":1378521815000},"page":"4267-4272","source":"Crossref","is-referenced-by-count":41,"title":["Successful Treatment of Tumor-Induced Osteomalacia due to an Intracranial Tumor by Fractionated Stereotactic Radiotherapy"],"prefix":"10.1210","volume":"98","author":[{"given":"Valentina D.","family":"Tarasova","sequence":"first","affiliation":[{"name":"Creighton University (V.D.T., A.G.T.-C.), Omaha, Nebraska 68131"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro G.","family":"Trepp-Carrasco","sequence":"additional","affiliation":[{"name":"Creighton University (V.D.T., A.G.T.-C.), Omaha, Nebraska 68131"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Thompson","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center (R.T.), Omaha, Nebraska 68198"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert R.","family":"Recker","sequence":"additional","affiliation":[{"name":"Creighton University (R.R.R.), Omaha, Nebraska 68131"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William H.","family":"Chong","sequence":"additional","affiliation":[{"name":"National Institutes of Health (W.H.C., M.T.C.), Bethesda, Maryland 20892"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael T.","family":"Collins","sequence":"additional","affiliation":[{"name":"Creighton University (L.A.G.A.), Omaha, Nebraska 68131"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura A. G.","family":"Armas","sequence":"additional","affiliation":[{"name":"Creighton University (V.D.T., A.G.T.-C.), Omaha, Nebraska 68131"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","reference":[{"key":"2020071615584042200_B1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1359\/JBMR.0301264","article-title":"FGF-23 is a potent regulator of vitamin D metabolism and phosphate homeostasis","volume":"19","author":"Shimada","year":"2004","journal-title":"J Bone Miner Res"},{"issue":"3","key":"2020071615584042200_B2","doi-asserted-by":"crossref","first-page":"R53","DOI":"10.1530\/ERC-11-0006","article-title":"Tumor-induced osteomalacia","volume":"18","author":"Chong","year":"2011","journal-title":"Endocr Relat Cancer"},{"key":"2020071615584042200_B3","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1111\/j.1365-2265.1992.tb02342.x","article-title":"Oncogenous osteomalacia and malignancy","volume":"37","author":"Harvey","year":"1992","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2020071615584042200_B4","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.anl.2008.01.003","article-title":"Malignant phosphaturic mesenchymal tumor, mixed connective tissue variant of the tongue","volume":"36","author":"Uramoto","year":"2009","journal-title":"Auris Nasus Larynx"},{"key":"2020071615584042200_B5","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1136\/jcp.30.4.328","article-title":"Hypophosphataemic osteomalacia associated with a malignant tumour of the tibia: report of a case","volume":"30","author":"Wyman","year":"1977","journal-title":"J Clin Pathol"},{"key":"2020071615584042200_B6","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s002560000306","article-title":"Recurrent malignant variant of phosphaturic mesenchymal tumor with oncogenic osteomalacia","volume":"30","author":"Ogose","year":"2001","journal-title":"Skeletal Radiol"},{"key":"2020071615584042200_B7","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1093\/rheumatology\/39.12.1415","article-title":"Four cases of acquired hypophosphataemic ('oncogenic') osteomalacia. 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