Endocrinologie et syndrome métabolique
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Tumour Induced Osteomalacia-Unique Presentation

Krishna Kumar Chinnadurai, Akshaya Jayachandran

Tumour-induced osteomalacia (TIO), also known as oncogenic osteomalacia is a rare paraneoplastic syndrome characterized by severe persistent hypophosphatemia. It occurs due to excess production of phosphatonins, which clinically manifests as severe hypophosphatemia. In our case, a 37-year-old woman presenting with multiple joint pains for last 9 years, progressive weakness of bilateral lower limbs for the last 1 year and past history of long bone fractures was diagnosed with tumor-induced osteomalacia (TIO) although she had normal FGF23 levels. TIO was caused by phosphaturic mesenchymal tumour in right tibia. After surgical resection of the tumour, her symptoms resolved. This is a unique case in that the patient had a normal systemic FGF23 level even with severe manifestations of TIO and also patient had raised parathyroid hormone levels which create a confusion of parathyroid related hypophosphatemia rather than the TIO. So a strong clinical suspicion is needed to diagnose TIO in such atypical cases.