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Record W4410386291 · doi:10.1136/bcr-2025-265058

Burosumab treatment of tumour-induced osteomalacia from a rib lesion

2025· article· en· W4410386291 on OpenAlexaff
Claire Song, Denise A. Chan, Elizabeth Kurien, Gregory Kline, Sana Ghaznavi

Bibliographic record

VenueBMJ Case Reports · 2025
Typearticle
Languageen
FieldMedicine
TopicParathyroid Disorders and Treatments
Canadian institutionsUniversity of Calgary
Fundersnot available
KeywordsMedicineOsteomalaciaFibroblast growth factor 23HypophosphatemiaLesionPathologySarcomaRadiologyInternal medicineOsteoporosis

Abstract

fetched live from OpenAlex

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.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Case report · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.575
Threshold uncertainty score0.594

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.042
GPT teacher head0.356
Teacher spread0.314 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designCase report
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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