Osteogenic osteomalacia

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Osteogenic osteomalacia (phosphaturic mesenchymal tumour, tumour-induced osteomalacia, tumor-induced osteomalacia, tumour induced osteomalacia, tumor induced osteomalacia, TIO) is a paraneoplastic syndrome caused by tumours that excrete fibroblast growth factor 23 (FGF-23). The patients exhibit[1]:

  1. Hypophosphataemia due to renal PO4 wasting.
  2. Inappropriately low/normal Vitamin D blood levels (presentation is as for osteomalacia, unresponsive to Vitamin D)
  3. Normal/evaluated FGF-23 blood levels
  4. A tumour often an osteosarcoma which may be initially occult