Both acromegaly and tumor-induced osteomalacia (TIO) are rare diseases caused by an excess hormone secreted by neuroendocrine neoplasms, which are growth hormone (GH) and fibroblast growth factor 23 (FGF23), respectively. GH elevates phosphate reabsorption via the effect of insulin-like factor 1 (IGF-1), while FGF23 inhibits phosphate reabsorption and reduces serum phosphate level markedly. A patient who developed a typical acromegaly appearance but was accompanied with height loss and hypophosphatemia for 2 years visited our hospital. Laboratory investigations showed GH and IGF-1 hypersecretion, as well as hypophosphatemia caused by renal phosphate wasting. Magnetic resonance image revealed a pituitary somatotroph adenoma. Octreoscan scintigraphy also found a causative tumor on the right foot for hypophosphatemia. Then, he underwent resection of the tumor on the right foot. His serum phosphate returned to normal immediately but elevated gradually. Then, we removed the pituitary adenoma of the patient, and the GH and phosphate levels returned to the normal range. Here, we report the first case with acromegaly combined with TIO, the changing process of his phosphate concentration suggests an interesting concurrent effect of excess GH and FGF23 in this rare condition.

中文翻译：

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肿瘤性骨软化症合并肢端肥大症一例

肢端肥大症和肿瘤诱发的骨软化症 (TIO) 都是由神经内分泌肿瘤分泌的激素过多引起的罕见疾病，这些激素分别是生长激素 (GH) 和成纤维细胞生长因子 23 (FGF23)。GH 通过胰岛素样因子 1 (IGF-1) 的作用提高磷酸盐重吸收，而 FGF23 抑制磷酸盐重吸收并显着降低血清磷酸盐水平。一位患有典型肢端肥大症但伴有身高下降和低磷血症 2 年的患者来我院就诊。实验室检查显示 GH 和 IGF-1 分泌过多，以及肾磷酸盐消耗引起的低磷血症。磁共振图像显示垂体生长激素腺瘤。Octreoscan 闪烁显像术还在右脚发现了导致低磷酸盐血症的肿瘤。然后，他接受了右脚肿瘤切除术。他的血清磷酸盐立即恢复正常但逐渐升高。然后，我们切除了患者的垂体腺瘤，GH和磷酸盐水平恢复到正常范围。在这里，我们报告了第一例肢端肥大症合并 TIO 的病例，他的磷酸盐浓度的变化过程表明，在这种罕见的情况下，过量的 GH 和 FGF23 会产生有趣的并发效应。