Osteomalacia and carcinoma of prostate with major redistribution of skeletal calcium

Abstract

A case of hypophosphataemic osteomalacia occurring in association with a carcinoma of prostate is described. Although only palliative treatment to the primary tumour was possible, worthwhile remission of bone symptoms, due to osteomalacia, was achieved with pharmacological doses of vitamin D. The presence of extensive skeletal metastases modified the radiological features of osteomalacia. Major alterations in the distribution of calcium within the skeleton were observed during a period when total body calcium remained unaltered. This observation may be of relevance to other cases in which osteosclerotic metastases develop.

Hyperparathyroidism in Metastases of Prostatic Carcinoma: A Biochemical, Hormonal and Histomorphometric Study

“…Osteomalacia is widely described in bone métastasés of prostatic cancer [3,4,[8][9][10] and continues to be a topic of special interest [17], although there have been few refer ences to a possible secondary HPTH [8]. Even recent reviews of the subject comment on the presence of hypo calcemia, but without mentioning the development of sec ondary HPTH [18].…”

“…This could be due [1]. These are known to produce bone pain, due to the bone lesion itself or the resultant osteomalacia [3,4], In turn, this osteomalacia, derived from the increased bone formation generated by the métastasés, produces the socalled bone hunger syndrome [5]. This syndrome occa sions hypocalcemia [6,7] and can lead to the develop ment of secondary hyperparathyroidism (HPTH) that can deteriorate the clinical condition still further.…”

Hypophosphataemic osteomalacia associated with a malignant tumour of the tibia: report of a case.

“…Electron microscopy confirms the mesenchymal nature of the tumour and the absence of neurosecretory granules, but there are no characteristic features in the cells which may help to elucidate their histogenesis. The recent report of the same type of osteomalacia in a patient with disseminated bone metastases from a prostatic carcinoma (Hosking et al, 1975) introduces new difficulties in the interpretation of the association of hypophosphataemic osteomalacia and neoplasia, but the association in this case could be coincidental.…”

Oncogenic Osteomalacia Associated with Metastatic Prostate Carcinoma: Case Report and Review of the Literature

“…Laboratory features include low serum 1,25(OH) 2 D, hypophosphatemia, and phosphaturia. Although almost exclusively associated with mesenchymal tumors, an association between prostate cancer and osteomalacia has been described in at least six subjects 1,2 . These six subjects together with the subject of this report, the oldest reported case, represent approximately 10% of all cases.…”