解放军医学院学报
解放軍醫學院學報
해방군의학원학보
Academic Journal of Chinese Pla Medical School
2013年
4期
405-407
,共3页
王颖倩%巴建明%王先令%吕朝晖%窦京涛%杜锦%谷伟军%杨国庆%杨丽娟%金楠%母义明
王穎倩%巴建明%王先令%呂朝暉%竇京濤%杜錦%穀偉軍%楊國慶%楊麗娟%金楠%母義明
왕영천%파건명%왕선령%려조휘%두경도%두금%곡위군%양국경%양려연%금남%모의명
肿瘤相关性低磷软骨病%颅面部肿瘤%奥曲肽%成纤维细胞生长因子%低磷血症
腫瘤相關性低燐軟骨病%顱麵部腫瘤%奧麯肽%成纖維細胞生長因子%低燐血癥
종류상관성저린연골병%로면부종류%오곡태%성섬유세포생장인자%저린혈증
tumor-induced osteomalacia%facies cranii neoplasms%octreotide%fibroblast growth factor%hypophosphatemia
目的通过对肿瘤相关性低磷软骨病(tumor-induced osteomalacia,TIO)的病例报道并文献复习,深化对该疾病的认识.方法本文报告2例中年女性病例,以往被误诊为类风湿关节炎,最终确诊为颅面部肿瘤所致TIO.病例1表现为弥漫性骨痛及肌无力4年,右眼内斜复视1个月;病例2表现为腰部及髋部骨痛伴进行性加重.生化检查均提示低血磷及尿磷排出增加.影像学检查在病例1和病例2中分别发现右侧颞骨岩尖部浸润性肿块和左侧鼻腔及筛窦软组织肿块.结果病例2的肿物被完全切除而病例1的肿物切除不完全.术后病理诊断均为混合结缔组织亚型的磷酸盐尿性间叶肿瘤.结论若患者表现为无法解释的持续低磷软骨病,应想到TIO的可能性(包括颅面部肿瘤引起的TIO),确诊依据病理,主要依靠手术治疗.
目的通過對腫瘤相關性低燐軟骨病(tumor-induced osteomalacia,TIO)的病例報道併文獻複習,深化對該疾病的認識.方法本文報告2例中年女性病例,以往被誤診為類風濕關節炎,最終確診為顱麵部腫瘤所緻TIO.病例1錶現為瀰漫性骨痛及肌無力4年,右眼內斜複視1箇月;病例2錶現為腰部及髖部骨痛伴進行性加重.生化檢查均提示低血燐及尿燐排齣增加.影像學檢查在病例1和病例2中分彆髮現右側顳骨巖尖部浸潤性腫塊和左側鼻腔及篩竇軟組織腫塊.結果病例2的腫物被完全切除而病例1的腫物切除不完全.術後病理診斷均為混閤結締組織亞型的燐痠鹽尿性間葉腫瘤.結論若患者錶現為無法解釋的持續低燐軟骨病,應想到TIO的可能性(包括顱麵部腫瘤引起的TIO),確診依據病理,主要依靠手術治療.
목적통과대종류상관성저린연골병(tumor-induced osteomalacia,TIO)적병례보도병문헌복습,심화대해질병적인식.방법본문보고2례중년녀성병례,이왕피오진위류풍습관절염,최종학진위로면부종류소치TIO.병례1표현위미만성골통급기무력4년,우안내사복시1개월;병례2표현위요부급관부골통반진행성가중.생화검사균제시저혈린급뇨린배출증가.영상학검사재병례1화병례2중분별발현우측섭골암첨부침윤성종괴화좌측비강급사두연조직종괴.결과병례2적종물피완전절제이병례1적종물절제불완전.술후병리진단균위혼합결체조직아형적린산염뇨성간협종류.결론약환자표현위무법해석적지속저린연골병,응상도TIO적가능성(포괄로면부종류인기적TIO),학진의거병리,주요의고수술치료.
Objective To deepen the understanding of tumor-induced osteomalacia (TIO) by reporting its cases and reviewing its relative literature. Methods Two middle-aged female cases of craniofacial TIO misdiagnosed as rheumatoid arthritis were reported. Case 1 was manifested as diffuse bone pain and muscle weakness for 4 years with right eye esotropia for 1 month. Case 2 was manifested as progressive bone pain in low back and hip for 2 years. Laboratory biochemical test showed hypophosphatemia and increased excretion of urophosphorus. Radiological examinations revealed an infiltrative tumor mass in right apex partis petrosae ossis temporalis in case 1, and a soft mass in left nasal cavity and ethmoid sinuses in case 2. Results The tumor was completely removed in case 2 and incompletely removed in case 1, which was pathologically diagnosed as a mixed connective tissue variant phosphaturic mesenchymal tumor. Conclusion The diagnosis of TIO including craniofacial TIO can be established by pathology when the patient is manifested as unexplained persistent osteomalacia and treated mainly by surgery.
