In Reply

Letters to the editor regarding the article Whole-Body Pain in a Case of a Phosphaturic Tumor by Konstantinos Anagnostakos, Ismail Sahan and Winfried Häuser in issue 26/2024

X-chromosomal hypophosphatemia mostly manifests in childhood; affected patients experience bone pain from childhood onwards (1). The patient reported progressive whole-body pain lasting a whole year (2). She had no clinical signs of X-chromosomal hypophosphatemia in adulthood, such as short stature (height 159 cm), dental anomalies, or mineralizing enthesopathy. Alkaline phosphatase was normal (54 U/L). We therefore did not examine her for X-chromosomal hypophosphatemia nor did we measure her serum klotho concentration.

The fact that the mesenchymal tumor—rather than other disorders—was the cause of the patient’s symptoms is confirmed by the completely re-normalized laboratory parameters and remission of the clinical symptoms after the tumor had been resected.

As regards the histological terminology, the phrase/term “phosphaturic mesenchymal tumor” is established in clinical practice and pathology (3) and is listed among the most recent ICD codes (4).

DOI: 10.3238/arztebl.m2025.0048

Prof. Dr. med. Konstantinos Anagnostakos, Dr. med. Ismail Sahan
Department of Orthopedics and Trauma Surgery, Klinikum Saarbrücken, Saarbrücken, Germany

Prof. Dr. med. Winfried Häuser, Klinik für Gastroenterologie, Hepatologie, Diabetologie, Endokrinologie und Infektiologie, Klinikum Saarbrücken

Conflict of interest statement

The authors of both letters to the editor declare that no conflict of interest exists.

References

1. Goischke A: X-chromosomale Hypophosphatämie (XLH): ein update zum interdisziplinären Management. Paediatrica 2024; 35: 26–30

2. Anagnostakos K, Sahan I, Häuser W: Whole-body pain in a case of a phosphaturic tumor. Dtsch Arztebl Int 2024; 121: 890

3. Sowell J, Srikakolapu S, Preda-Naumescu A, et al.: Phosphaturic mesenchymal tumor: a case report and review of surgical outcomes in elderly patients. JAAD Case Rep 2021; 19: 34–6

4. www.klassifikationen.bfarm.de/icd-o-3/icd03rev2html/block-893-899.htm (last accessed on 24 February 2025).