Case Report
Atypical Fragility Fractures due to Bony or Soft Tissue Phosphaturic Mesenchymal Tumors: A Report of Two Cases
Table 1
Pre- and post-operative blood and urine laboratory values for Case 2. Excess FGF23 produced by a PMT promotes renal phosphate excretion and suppresses the production of active vitamin D (1,25-OH2-Vitamin D), leading to renal phosphate wasting, hypophosphatemia, elevated alkaline phosphatase, and secondary hyperparathyroidism. The rapid fall in intact FGF23 after tumor removal induces a rebound in 1,25-OH2-Vitamin D production and increased calcium requirements as the skeleton begins to remineralize. Concurrently, renal phosphate excretion decreases, and blood phosphate levels return to normal [17].
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DOS = day of surgery; POD = post-operative day. |