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Preoperative tumor ...
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Westerberg, Per-AntonDepartments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
(author)
Preoperative tumor localization by means of venous sampling for fibroblast growth factor-23 in a patient with tumor-induced osteomalacia
- Article/chapterEnglish2008
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LIBRIS-ID:oai:DiVA.org:uu-88397
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-88397URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-53714URI
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https://doi.org/10.4158/EP.14.3.362DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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OBJECTIVE: To report on a novel strategy for tumor localization in a 62-year-old man with hypophosphatemic tumor-induced osteomalacia (TIO). METHODS: Repeated computed tomographic and magnetic resonance imaging scans failed to localize any tumor in a patient with adult-onset hypophosphatemic osteomalacia. Therefore, venous sampling for fibroblast growth factor-23 (FGF23)--a circulating hormone that has been identified as a causative factor for TIO--in major veins was conducted. Serum FGF23 was measured from collected samples by an intact FGF23 enzyme-linked immunosorbent assay. RESULTS: Venous sampling suggested a local increase in serum FGF23 in the left femoral vein; this finding prompted performance of octreotide scintigraphy restricted to the left leg. A tumor was located at the lateral condyle of the left femur, which was also confirmed by magnetic resonance imaging. Surgical resection of the tumor normalized the serum phosphorus and 1,25-dihydroxyvitamin D3 levels within 5 to 10 days, and FGF23 declined to normal levels within 24 hours. Histologic analysis supported the diagnosis of a soft-tissue giant cell tumor. CONCLUSION: Our study case demonstrates the diagnostic complexity and difficulties in localizing a small tumor in a patient with TIO. Venous sampling for FGF23 may be helpful in tumor localization in sporadic cases of hypophosphatemic osteomalacia, especially when noninvasive diagnostic techniques prove insufficient.
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Olauson, HannesDepartments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
(author)
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Toss, GöranÖstergötlands Läns Landsting,Linköpings universitet,Internmedicin,Hälsouniversitetet,Endokrin- och magtarmmedicinska kliniken US(Swepub:liu)gorto76
(author)
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Wikström, BjörnDepartments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
(author)
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Morales, OllalloÖstergötlands Läns Landsting,Linköpings universitet,Institutionen för medicin och hälsa,Hälsouniversitetet,Röntgenkliniken i Linköping
(author)
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Linde, Torbjörn,1957-Uppsala universitet,Institutionen för medicinska vetenskaper,Departments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden(Swepub:uu)torblind
(author)
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Jonsson, KennethDepartments of Surgical Science, Uppsala University Hospital, Uppsala, Sweden
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Ljunggren, ÖstenDepartments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
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Larsson, Tobias E.Departments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
(author)
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Departments of Medical Sciences, Uppsala University Hospital, Uppsala, SwedenInternmedicin
(creator_code:org_t)
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In:Endocrine Practice14:3, s. 362-71530-891X1934-2403
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Westerberg, Per- ...
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Olauson, Hannes
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Toss, Göran
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Wikström, Björn
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Morales, Ollallo
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Linde, Torbjörn, ...
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Jonsson, Kenneth
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Ljunggren, Östen
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Endocrine Practi ...
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