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An 87-year-old woman was referred to the endocrinology clinic in 1979 for hypophosphatemia (serum phosphate level consistently <1.5 mg per deciliter [0.48 mmol per liter]) causing cramps and myalgia; tumor-induced osteomalacia was diagnosed. A radiograph of the hand showed a lytic lesion at the third metacarpal bone (Panel A, arrow). Results of a complete skeletal survey were negative. The patient declined biopsy and tumor resection but agreed to receive therapy with phosphate and calcitriol; there was some improvement in her serum phosphate levels, although normalization was never achieved. Although periodically lost to follow-up, the patient remained otherwise healthy, with no . . . [Full Text of this Article] |
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