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肿瘤相关性低血磷性骨软化症为罕见疾病。本文报道1例39岁男性,10余年前起逐渐出现乏力、多部位骨痛,进行性加重的活动困难,辅助检查提示低血磷,高尿磷,血钙正常,碱性磷酸酶(ALP)轻度增高,血pH正常,影像学有骨质疏松及骨软化表现,可见肋骨多发骨折,椎体双凹变。诊断为低血磷性骨软化症,因其成年起病,且无家族史,考虑肿瘤相关性低血磷性骨软化症可能性大,分别于2004年及2006年2次住院均未能明确定位诊断,对症服用中性磷制剂后症状明显改善。2010年第3次入院后通过PET-CT、奥曲肽显像及CT检查发现右股骨头内有占位性病变,行手术切除,术后血磷恢复正常,临床症状改善,病理学检查证实为磷酸盐尿性间叶组织肿瘤。
Tumor-associated hypophosphatemia is a rare disease. This article reports a 39-year-old man, more than 10 years ago, the gradual emergence of fatigue, multiple parts of bone pain, progressive aggravating activity difficulties, auxiliary examination suggest hypophosphatemia, high urinary phosphorus, normal serum calcium, alkaline phosphatase (ALP) Mild increase, normal blood pH, imaging osteoporosis and osteomalacia showed multiple rib fractures, vertebral biconcave. Diagnosis of hypophosphatemia osteomalacia, due to their age onset, and no family history, consider the possibility of tumor-associated hypophosphatemia osteomalacia, respectively, in 2004 and 2006 were not clear in 2 hospitalizations Positioning diagnosis, symptomatic treatment of neutral phosphorus preparations significantly improved symptoms. After the third admission in 2010, PET-CT, octreotide imaging and CT examination revealed a space-occupying lesion in the right femoral head. Surgical resection was performed. The postoperative serum phosphorus was recovered and the clinical symptoms were improved. The pathological examination was confirmed as phosphoric acid Saline urine mesenchymal tumor.