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

IF 3.5 Q2 ONCOLOGY

JTO Clinical and Research Reports Pub Date : 2025-03-08 DOI:10.1016/j.jtocrr.2025.100822

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

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Abstract

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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fgf23扩增的肺腺癌和fgf23缺失的SCLC患者的肿瘤诱导骨软化：病例报告

肿瘤诱导骨软化症（TIO）是一种罕见的副肿瘤综合征，其特征是异位成纤维细胞生长因子-23 （FGF23）的产生。我们报告一个独特的病例78岁女性患者难治性低磷血症，最终诊断为TIO，在两种转移性原发性肺癌：腺癌和SCLC的背景下。肿瘤样本的分子分析显示，一个腺癌样本中FGF23扩增，一个SCLC样本中FGF23缺失，表明肿瘤FGF23分子改变与血清FGF23水平升高之间存在潜在联系。该病例强调了与实体瘤相关的TIO诊断和管理的复杂性，并强调了对这种情况的认识以防止诊断延误的必要性。未来的研究应该探索FGF23改变与癌症进展之间的联系机制，并在耐药转移性癌症的背景下评估TIO的靶向治疗。

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