ABSTRACT
OBJECTIVE: To document the course and reversal of avascular necrosis of the femoral heads (ANFH) in a 27-year-old woman with tumor-induced osteomalacia (TIO). METHODS: We describe clinical, biochemical, and magnetic resonance imaging changes in a patient who sought medical assistance because of pain in her back, hips, and knees and an enlarging mass on her right thigh. RESULTS: The patient proved to have TIO, an unusual condition characterized by humorally controlled renal phosphate wasting, low to undetectable levels of 1,25-dihydroxyvitamin D(3), and osteomalacia. Eleven months after removal of a small spindle cell tumor of the right thigh and without other treatment, complete clinical and biochemical remission was observed, and the magnetic resonance images revealed resolution of the ANFH. CONCLUSION: Prompt treatment of ANFH in TIO can lead to complete radiologic and clinical remission.
