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The Japanese Journal of Thoracic Surgery Volume 72, Issue 8 （August 2019）

胸部外科 72巻8号（2019年8月発行）

Japanese English

今月の話題

胸壁発生腫瘍による腫瘍性低リン血症性骨軟化症 Tumor-induced Hypophosphatemic Osteomalacia Caused by a Chest Wall Tumor 金泰雄 ¹ , 小川裕行 ¹ , 松本学 ¹ , 光井卓 ¹ , 松本高典 ¹ , 西岡祐希 ¹ , 酒井秀都 ¹ , 木村賢司 ¹ , 清水奈保子 ¹ , 法華大助 ¹ , 田中雄悟 ¹ , 眞庭謙昌 ¹ Yasuo Kin ¹ , Hiroyuki Ogawa ¹ , Gaku Matsumoto ¹ , Suguru Mitsui ¹ , Takanori Matsumoto ¹ , Yuki Nishioka ¹ , Syuto Sakai ¹ , Kenji Kimura ¹ , Nahoko Shimizu ¹ , Daisuke Hokka ¹ , Yugo Tanaka ¹ , Yoshimasa Maniwa ¹ ¹神戸大学呼吸器外科 ¹Department of Thoracic Surgery, Kobe University キーワード：腫瘍性低リン血症性骨軟化（TIO） , 胸壁腫瘍 Keyword: tumor-induced hypophosphatemic osteomalacia （TIO） , chest wall tumor pp.570-573

発行日 2019年8月1日 Published Date 2019/8/1

DOI https://doi.org/10.15106/j_kyobu72_570

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Abstract 文献概要
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参考文献 Reference

腫瘍性低リン血症性骨軟化症（TIO）は，腎尿細管リン再吸収障害による低リン血症，くる病（骨軟化症）などを特徴とする腫瘍随伴症候群の一つである1）．胸部外科領域における報告はまれであり，文献的考察を加えて報告する．

Tumor-induced osteomalacia （TIO） is a rare paraneoplastic disease characterized by hypophosphatemia and skeletal undermineralization. Overproduction of fibroblast growth factor 23 （FGF23） from the responsible tumor is reported to be a causative factor. Removing the tumor is the only effective treatment for TIO, but identifying the tumor is sometimes difficult. A 43-year-old man complained of heel pain 4 years earlier, and the pain gradually expanded to the whole body. As a blood test showed the elevation of the serum FGF23 level and hypophosphatemia, he was diagnosed with FGF23-related hypophosphatemia. Chest computed tomography （CT） showed a 10-mm nodule in the right chest wall. Venous sampling for FGF23 revealed considerable elevation of the FGF23 level in the right subclavian vein. Therefore, a chest wall tumor was suspected as the tumor responsible for TIO, and surgical resection was performed. After surgery, hypophosphatemia improved within several days, and the FGF23 level also normalized.