• J L Dupond, N Magy, M Mahammedi, D Prie, H Gil, N Meaux-Ruault, and B Kantelip.
• Service de médecine interne, hôpital Jean-Minjoz, boulevard Fleming 25030 Besançon cedex, France. jean-louis.dupond@ufc-chu.univ-fcomte.fr
• Rev Med Interne. 2005 Mar 1; 26 (3): 238-41.

IntroductionOncogenic osteomalacia (OO) is a rare paraneoplastic syndrome characterized by severe hypophosphatemia induced by phosphaturic factors which are secreted by some tumors of mesenchymal origin. Fibroblast Growth Factor 23 (FGF-23) belongs to this family. Measurement of FGF-23 might improve the diagnosis of OO.ExegesisWe report the case of 71-year-old Caucasian man who had a history of severe osteomalacia with multiples fractures and extreme hypophosphatemia with hyperphosphaturia and normal serum calcium level. Serum FGF-23 was 199 RU/ml (N < 100 RU/ml). The tumor, detected by F-18 FDG PET/CT SCAN was localized in the mandible. Surgical removal of the tumor relieved all symptoms with normalization of serum phosphate levels within 3 days after surgery.ConclusionWe conclude that FGF-23 measurement is likely to be of considerable importance for facilitating early diagnosis of OO.

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