Tumor-Induced Osteomalacia in a Patient With FGF23-Amplified Lung Adenocarcinoma and FGF23-Deleted SCLC: Case Report

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by ectopic fibroblast growth factor-23 (FGF23) production. We report a unique case of a 78-year-old female patient with refractory hypophosphatemia, ultimately diagnosed as TIO, in the context of two metastatic primary...

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Main Authors: Marcello Moro Queiroz, MD, Ricardo Dahmer Tiecher, MD, João Felipe Lima Feldmann, MD, Elisangela Monteiro Coser, BSc, Mariana Vargas Cruz, PhD, Livia Loureiro, PhD, Gabriela Franco Katz, MD, Marina Henkin Behar, MD, João Victor Machado Alessi, MD, Leonardo de Abreu Testagrossa, PhD, Anamaria Aranha Camargo, PhD, Paula Fontes Asprino, PhD, Fabiana Bettoni, PhD, Artur Katz, MD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JTO Clinical and Research Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666364325000384
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author Marcello Moro Queiroz, MD
Ricardo Dahmer Tiecher, MD
João Felipe Lima Feldmann, MD
Elisangela Monteiro Coser, BSc
Mariana Vargas Cruz, PhD
Livia Loureiro, PhD
Gabriela Franco Katz, MD
Marina Henkin Behar, MD
João Victor Machado Alessi, MD
Leonardo de Abreu Testagrossa, PhD
Anamaria Aranha Camargo, PhD
Paula Fontes Asprino, PhD
Fabiana Bettoni, PhD
Artur Katz, MD
author_facet Marcello Moro Queiroz, MD
Ricardo Dahmer Tiecher, MD
João Felipe Lima Feldmann, MD
Elisangela Monteiro Coser, BSc
Mariana Vargas Cruz, PhD
Livia Loureiro, PhD
Gabriela Franco Katz, MD
Marina Henkin Behar, MD
João Victor Machado Alessi, MD
Leonardo de Abreu Testagrossa, PhD
Anamaria Aranha Camargo, PhD
Paula Fontes Asprino, PhD
Fabiana Bettoni, PhD
Artur Katz, MD
author_sort Marcello Moro Queiroz, MD
collection DOAJ
description Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by ectopic fibroblast growth factor-23 (FGF23) production. We report a unique case of a 78-year-old female patient with refractory hypophosphatemia, ultimately diagnosed as TIO, in the context of two metastatic primary lung cancers: adenocarcinoma and SCLC. Molecular analyses of tumor samples highlighted FGF23 amplification in one adenocarcinoma sample and FGF23 deletion in one SCLC sample, suggesting a potential link between tumor FGF23 molecular alterations and elevated serum FGF23 levels. This case underscores the complexity of diagnoses and management of TIO when associated with solid tumors and highlights the need for awareness of this condition to prevent diagnostic delays. Future research should explore the mechanisms linking FGF23 alterations and cancer progression and evaluate targeted therapies for TIO in the context of resistant metastatic cancers.
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institution Kabale University
issn 2666-3643
language English
publishDate 2025-06-01
publisher Elsevier
record_format Article
series JTO Clinical and Research Reports
spelling doaj-art-050888bd159b4e82a4651264ddf893702025-08-20T03:24:52ZengElsevierJTO Clinical and Research Reports2666-36432025-06-016610082210.1016/j.jtocrr.2025.100822Tumor-Induced Osteomalacia in a Patient With FGF23-Amplified Lung Adenocarcinoma and FGF23-Deleted SCLC: Case ReportMarcello Moro Queiroz, MD0Ricardo Dahmer Tiecher, MD1João Felipe Lima Feldmann, MD2Elisangela Monteiro Coser, BSc3Mariana Vargas Cruz, PhD4Livia Loureiro, PhD5Gabriela Franco Katz, MD6Marina Henkin Behar, MD7João Victor Machado Alessi, MD8Leonardo de Abreu Testagrossa, PhD9Anamaria Aranha Camargo, PhD10Paula Fontes Asprino, PhD11Fabiana Bettoni, PhD12Artur Katz, MD13Oncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil; Corresponding author. Address for correspondence: Marcello Moro Queiroz, MD, Oncology Center, Hospital Sírio-Libanês, Street Adma Jafet, number 115, São Paulo, São Paulo, 01308-050, Brazil.Oncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilOncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilMolecular Oncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilDepartment of Pathology, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilMedical Affairs Organization, Illumina, São Paulo, São Paulo, BrazilUniversity of Central Lancashire, Preston, United KingdomOncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilOncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilDepartment of Pathology, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilMolecular Oncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilMolecular Oncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilMolecular Oncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilOncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, BrazilTumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by ectopic fibroblast growth factor-23 (FGF23) production. We report a unique case of a 78-year-old female patient with refractory hypophosphatemia, ultimately diagnosed as TIO, in the context of two metastatic primary lung cancers: adenocarcinoma and SCLC. Molecular analyses of tumor samples highlighted FGF23 amplification in one adenocarcinoma sample and FGF23 deletion in one SCLC sample, suggesting a potential link between tumor FGF23 molecular alterations and elevated serum FGF23 levels. This case underscores the complexity of diagnoses and management of TIO when associated with solid tumors and highlights the need for awareness of this condition to prevent diagnostic delays. Future research should explore the mechanisms linking FGF23 alterations and cancer progression and evaluate targeted therapies for TIO in the context of resistant metastatic cancers.http://www.sciencedirect.com/science/article/pii/S2666364325000384Tumor-induced osteomalaciaLung adenocarcinomaFibroblast growth factor-23Case report
spellingShingle Marcello Moro Queiroz, MD
Ricardo Dahmer Tiecher, MD
João Felipe Lima Feldmann, MD
Elisangela Monteiro Coser, BSc
Mariana Vargas Cruz, PhD
Livia Loureiro, PhD
Gabriela Franco Katz, MD
Marina Henkin Behar, MD
João Victor Machado Alessi, MD
Leonardo de Abreu Testagrossa, PhD
Anamaria Aranha Camargo, PhD
Paula Fontes Asprino, PhD
Fabiana Bettoni, PhD
Artur Katz, MD
Tumor-Induced Osteomalacia in a Patient With FGF23-Amplified Lung Adenocarcinoma and FGF23-Deleted SCLC: Case Report
JTO Clinical and Research Reports
Tumor-induced osteomalacia
Lung adenocarcinoma
Fibroblast growth factor-23
Case report
title Tumor-Induced Osteomalacia in a Patient With FGF23-Amplified Lung Adenocarcinoma and FGF23-Deleted SCLC: Case Report
title_full Tumor-Induced Osteomalacia in a Patient With FGF23-Amplified Lung Adenocarcinoma and FGF23-Deleted SCLC: Case Report
title_fullStr Tumor-Induced Osteomalacia in a Patient With FGF23-Amplified Lung Adenocarcinoma and FGF23-Deleted SCLC: Case Report
title_full_unstemmed Tumor-Induced Osteomalacia in a Patient With FGF23-Amplified Lung Adenocarcinoma and FGF23-Deleted SCLC: Case Report
title_short Tumor-Induced Osteomalacia in a Patient With FGF23-Amplified Lung Adenocarcinoma and FGF23-Deleted SCLC: Case Report
title_sort tumor induced osteomalacia in a patient with fgf23 amplified lung adenocarcinoma and fgf23 deleted sclc case report
topic Tumor-induced osteomalacia
Lung adenocarcinoma
Fibroblast growth factor-23
Case report
url http://www.sciencedirect.com/science/article/pii/S2666364325000384
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