ArticleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2011
Selective venous catheterization for the localization of phosphaturic mesenchymal tumors.
Article in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers.
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Who cites it
58 citing papers in PubMed, 125 citations in OpenAlex.
- Surgical treatment as a key determinant of outcome in phosphaturic mesenchymal tumors of the bone and soft tissue: a systematic review and case series.EFORT open reviews · 2025Article
- Two Cases of Tumor-induced Osteomalacia Resulting in Surgical Resection during Burosumab Therapy.Internal medicine (Tokyo, Japan) · 2025Article
- Treatment Advances in Tumor-Induced Osteomalacia.Calcified tissue international · 2025Review
- Diagnostic approach to rickets: an Endocrine Society of Bengal (ESB) consensus statement.Annals of pediatric endocrinology & metabolism · 2024Article
- A Rare Association Between Osteomalacia, Phosphaturic Mesenchymal Tumor, and Ovarian Cancer: A Case Report and Literature Review.Calcified tissue international · 2024Review
- Successful Superficial Blood Sampling to Localize a Fibroblast Growth Factor-23-Producing Tumor.The American journal of case reports · 2024Article
- [Clinical features, diagnostics and treatment of FGF23 secreting tumors: series of 40 clinical cases].Problemy endokrinologii · 2023Article
- Global guidance for the recognition, diagnosis, and management of tumor-induced osteomalacia.Journal of internal medicine · 2023Review
- A Case of Tumor-Induced Osteomalacia Detected by Venous Sampling.International medical case reports journal · 2023Article
- Utility of Multimodality Approach Including Systemic FGF23 Venous Sampling in Localizing Phosphaturic Mesenchymal Tumors.Journal of the Endocrine Society · 2022Article
- Tumour-induced osteomalacia: a rare cause of chronic pain and weakness.Practical neurology · 2022Article
- Disorders of phosphate homeostasis in children, part 2: hypophosphatemic and hyperphosphatemic disorders.Pediatric radiology · 2022Review
- Tumor-induced osteomalacia characterized by "painful knee joint with difficulty in moving": a case report.BMC endocrine disorders · 2022Article
- Phosphaturic mesenchymal tumors: radiological aspects and suggested imaging pathway.La Radiologia medica · 2021Review
- Hypophosphatemia in cancer patients.Clinical kidney journal · 2021Article
- Persistent phosphaturic mesenchymal tumor causing tumor-induced osteomalacia treated with image-guided ablation.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- Diagnosis and Management of Tumor-induced Osteomalacia: Perspectives From Clinical Experience.Journal of the Endocrine Society · 2021Article
- Comparison ofOrthopaedic surgery · 2021Article
- A Normal FGF23 Does Not Preclude Tumor-Induced Osteomalacia.JBMR plus · 2021Article
- Tumor-Induced Osteomalacia.Calcified tissue international · 2021Review
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
Tumor-induced osteomalacia (TIO) is characterized by renal phosphate wasting, hypophosphatemia, and aberrant vitamin D(3) metabolism and is caused by fibroblast growth factor 23 (FGF-23)-producing mesenchymal tumors, which are often difficult to locate. We investigated the utility of selective venous sampling in tumor localization. The primary endpoint was identification of the FGF-23 concentration ratio between the venous drainage of the tumor bed and the general circulation that was diagnostic of the location of an FGF-23-secreting tumor. Fourteen subjects underwent 15 sampling procedures after functional and anatomic imaging studies. Subjects fit into three imaging categories: no suspicious site, multiple sites, and single site (positive controls). FGF-23 levels were measured by ELISA. Suspicious tumors were resected for diagnosis, confirmation, and cure. In subjects with a positive venous sampling study and subsequent cure, a minimum ratio of 1.6 was diagnostic. In 7 of 14 subjects there was suggestive imaging, a diagnostic ratio, and an associated TIO tumor (true positive). Four of these required complicated resection procedures. In 4 of 14 subjects with no suspicious site on imaging studies, an FGF-23 diagnostic ratio was not detected (true negative). Biopsy or resection of a single lesion in 2 of 14 subjects with a diagnostic ratio failed to identify a TIO tumor (false positive). A diagnostic FGF-23 ratio was absent in 1 of 14 subjects whose tumor was a single highly suspicious lesion on imaging studies (false negative). These data yield a sensitivity of 0.87 [95% confidence interval (CI) 0.47-0.99] and a specificity of 0.71 (95% CI 0.29-0.96). Selective venous sampling for FGF-23 was particularly useful in subjects with multiple suspicious sites or an anatomically challenging planned resection but not in the absence of a suspicious lesion on imaging studies.
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