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Oncogenic osteomalacia is a paraneoplastic syndrome usually induced by bone or soft tissue tumors. It is presented by the development of pain and fractures with hypophosphatemia, hyperphosphaturia, and inappropriate normal/low plasma 1,25(OH)2D3 concentration. After the removal of the tumor the complete resolution of all biochemical and clinical abnormalities is the main characteristic. A case of a 44-year-old female with difficulty in walking due to leg pain and generalized muscle weakness and hypophosphatemia, with relative hyperphosphaturia, is described. A whole-body 99mTc-sestamibi scintigraphy showed accumulation in the left thigh region, and a small tumor was detected by ultrasound examination. By removal of the tumor, a lipoma, the symptoms improved significantly after a month, with complete recovery by the fourth month. In this case, 99mTc-sestamibi scintigraphy was useful in identifying the location of the tumor, which caused oncogenic osteomalacia.
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http://dx.doi.org/10.1590/s0004-27302008000900016 | DOI Listing |
JCEM Case Rep
October 2025
Department of Neurological Surgery, Sidney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia, PA.
A 73-year-old woman with a remote history of successfully treated primary hyperparathyroidism was referred to our office because of multiple skeletal fractures and proximal muscle weakness. Prior laboratory evaluation demonstrated hypocalcemia, vitamin D deficiency, elevated PTH, and elevated alkaline phosphatase. Updated evaluation in our clinic additionally showed hypophosphatemia prompting measurement of serum fibroblast growth factor 23 (FGF23).
View Article and Find Full Text PDFBMC Musculoskelet Disord
September 2025
The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Background: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by mesenchymal tumors that secrete fibroblast growth factor 23 (FGF23). Phosphaturic mesenchymal tumor (PMT) is a novel histopathologic entity that has been identified as a separate cause of TIO. Clinically, PMT is typically diagnosed late due to its rarity.
View Article and Find Full Text PDFPersistent hypophosphatemia must prompt thorough evaluation. This case highlights the severe, multisystem consequences of delayed recognition of oncogenic osteomalacia. Early biochemical assessment, imaging, and multidisciplinary involvement are critical to avoid misdiagnosis and prevent irreversible complications such as skeletal fragility and cardiomyopathy.
View Article and Find Full Text PDFJCEM Case Rep
September 2025
Department of Anatomical Pathology, Division of Pathology, Singapore General Hospital, Singapore 169608, Singapore.
Ectopic expression of PTH in nonmetastatic prostate cancer is a rare occurrence. We present a case of a 60-year-old Chinese man who initially presented with hyperparathyroidism, PTH 80.1 pg/mL (SI: 8.
View Article and Find Full Text PDFCalcif Tissue Int
June 2025
Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
Tumor-induced osteomalacia (TIO) is an ultrarare paraneoplastic syndrome due to the overproduction of Fibroblast Growth Factor 23 (FGF23). Although other phosphate-regulating substances (i.e.
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