porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo12948porozendo-12948Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCASE REPORTКлинический случай фосфопенической формы остеомаляции вследствие паранеопластической секреции метастатического рака предстательной железыA clinical case of phosphopenic osteomalacia due to paraneoplastic secretion of metastatic prostate cancehttps://orcid.org/0000-0001-7055-2407ГронскаяС. А.GronskayaS. A.

Гронская Софья Александровна, аспирант

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Sofya A. Gronskaya, MD

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sofyaants@gmail.comhttps://orcid.org/0000-0003-2320-1051ГолоунинаО. О.GolouninaO. O.

Голоунина Ольга Олеговна, студент

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Olga O. Golounina, Student, Medical faculty

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olga.golounina@mail.ruhttps://orcid.org/0000-0002-0039-2118БуклемишевЮ. В.BuklemishevYu. V.

Буклемишев Юрий Витальевич

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Yuri V. Buklemishev, MD

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buklemishev@mail.ruhttps://orcid.org/0000-0002-6758-5918ХайриеваА. В.KhairievaA. V.

Хайриева Ангелина Владимировна

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Angelina V. Khairieva, MD

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komarito@mail.ruhttps://orcid.org/0000-0001-5652-2607ДегтяревМ. В.DegtyarevM. V.

Дегтярев Михаил Владимирович

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Mikhail V. Degtyarev, MD

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germed@mail.ruhttps://orcid.org/0000-0001-7041-0732РожинскаяЛ. Я.RozhinskayaL. Ya.

Рожинская Людмила Яковлевна д.м.н., профессор

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Белая Жанна Евгеньевна, д.м.н., профессор

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Zhanna E. Belaya, MD, PhD, Professor

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jannabelaya@gmail.comФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава РоссииРоссияThe National Medical Research Center for Endocrinology of the Ministry of Health of the Russian FederationRussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian FederationФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Приорова» Минздрава РоссииРоссияThe National Medical Research Center of Traumatology and Orthopedics named after N.N. PriorovRussian Federation2022130120232544351Copyright © Гронская С.А., Голоунина О.О., Буклемишев Ю.В., Хайриева А.В., Дегтярев М.В., Рожинская Л.Я., Белая Ж.Е., 20232023Гронская С.А., Голоунина О.О., Буклемишев Ю.В., Хайриева А.В., Дегтярев М.В., Рожинская Л.Я., Белая Ж.Е.Gronskaya S.A., Golounina O.O., Buklemishev Y.V., Khairieva A.V., Degtyarev M.V., Rozhinskaya L.Y., Belaya Z.E.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/12948

Фосфатурическая мезенхимальная опухоль может служить причиной остеомаляции из-за избыточной секреции фактора роста фибробластов 23 (ФРФ23), нарушающего метаболизм фосфора и витамина D. Образования преимущественно доброкачественные, однако менее чем в 5% встречаются злокачественные формы. В статье представлен первый в Российской Федерации клинический случай пациента 69 лет с выраженной гипофосфатемией, вследствие метастатического рака предстательной железы.  Именно для андроген-нечувствительной формы описана возможность секреции ФРФ23, что привело к выраженным нарушениям минерального обмена, сопровождающихся клинической картиной слабости, болевым синдромом в костях, обездвиживанием пациента. Состояние было расценено как ухудшение на фоне прогрессирования заболевания. Однако симптоматическая терапия, направленная на повышение уровня фосфора в организме, позволила значительно улучшить общее состояние пациента. Медицинское сообщество должно быть осведомлено о возможности развития гипофосфатемии у пациентов со слабостью, болью в костях на фоне метастатического рака предстательной железы.

Phosphaturic mesenchymal tumor can cause osteomalacia due to excessive secretion of fibroblast growth factor 23 (FGF23), which disrupts the metabolism of phosphate and vitamin D. These tumors are predominantly benign, but less than 5% of them are malignant forms. This article presents the first clinical case in the Russian Federation of a 69-year-old patient with severe hypophosphatemia due to metastatic prostate cancer. Increased secretion of FGF23 are described in the androgen-resistent prostate cancer, which led to pronounced disorders of mineral metabolism, accompanied by a clinical symptom of weakness, pain in the bones, immobilization of the patient. The condition was regarded as worsening against the background of the progression of the disease. However, symptomatic therapy aimed at increasing the level of phosphate significantly improved the patient’s general condition. The medical community should be aware of the possibility of developing hypophosphatemia in patients with weakness and bone pain, which are not always associated with the progression of metastatic prostate cancer.

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The authors declare that there are no conflicts of interest present.