Burosumab treatment of tumour-induced osteomalacia from a rib lesion
Bibliographic record
Abstract
Tumour-induced osteomalacia (TIO) is a rare cause of acquired hypophosphataemia most often due to paraneoplastic overproduction of fibroblast growth factor-23 (FGF-23). A woman in her 60s presented with an 18 month history of insidious back, knee and ankle pain, and progressive weakness. Biochemistry revealed low serum phosphate and a bone scan showed diffuse bony lesions, initially suspected to be metastatic sarcoma given her history of uterine sarcoma. However, a positron emission tomography scan identified a solitary destructive lytic lesion in the right posterior second rib. Endocrine workup showed low serum phosphate, high fractional excretion of phosphate, normal 25-hydroxyvitamin D and elevated FGF-23 levels. A biopsy revealed spindle cell neoplasm, which later stained positive for FGF receptor 1, consistent with renal phosphate wasting secondary to TIO. The patient was started on burosumab, a human monoclonal antibody against FGF-23, which normalised her serum phosphate and led to marked clinical improvement. She is now awaiting curative surgery for the primary rib lesion.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".