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Tumour-induced osteomalacia caused by a nodule of the palm
  1. Shuzhong Liu1,
  2. Xi Zhou1,
  3. An Song2,
  4. Zhen Huo3,
  5. Yipeng Wang1,
  6. Yong Liu1
  1. 1 Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
  2. 2 Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
  3. 3 Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
  1. Correspondence to Yong Liu, Department of Orthopedic Surgery, Peking Union Medical College Hospital, Dongcheng-qu, Beijing, 100730, China; liuyong_pumch{at}163.com

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A 65-year-old man presented to orthopaedic clinic with an 8-year history of hypophosphataemia and severe systemic multiple bone pain. The patient stated that there was a nodule in the centre of his left palm with the size of 0.5×0.5 × 0.5 cm initially, and it gradually increased to 4.0×3.0 × 1.0 cm during the past 5 years and the tenderness was positive. He denied experiencing any other constitutional symptoms or any history of trauma in the past years. Physical examination revealed a mass in the left palm sized 4.0×3.0 cm, with tenderness and poor mobility. Laboratory tests revealed hypophosphataemia and elevated expression of fibroblast growth factor 23. MRI of the hand showed a nodule in the centre of the left palm, which appeared as inhomogeneous lesion with hyperintense on T2-weighted image (T2WI) (figure 1A, B). We performed a first-line 68Ga-DOTA-TATE positron emission tomography/computed tomography (PET/CT) (68 …

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