Case of bone pain with ear pain
A 28 y/o male presented with diffuse bone pain. Report shows low level of serum phosphorus (0.8 mg/dl), hyperphosphaturia and hypercalcemia and was diagnosed with hypophosphatemic osteomalacia. Tumor was found in his left middle ear & right sphenoid wing that infiltrated into the floor of the middle cranial fossa. What should be done?
Fast growing malignant tumor of middle ear metastatic to cranium Need to differentiate osteomalacia Or multiple myeloma Pt has hypophosphtemsia with hypercalcimia suggestive of hyperparathyroidism need to r/o primary there Hence ct brain Pet scan parathyroid Rest of markers Rx will depend final dx and under oncologist
Hypercalcemia and hypophosphatemia are typically associated with hyperparathyroidism Malignant cells can produce parathyroid hormone related peptide which has action similar to parathyroid hormone, which can result in hypercalcemia with hypophosphatemia It is also called as paraneoplastic syndrome caused by malignancy Adv PET CT, bone scan to look for metastatic lesion
accoustic neuroma refer to surgical onco
I think consult with a ENT SPECIALIST OR SURGEON for the better treatment and management.
Go for ent specialist
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