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CC BY-NC-ND 4.0 · South Asian J Cancer
DOI: 10.1055/s-0043-1768681
Original Article

Tumor-Induced Osteomalacia: A Case Report of Rare Disease and Literature review

Shivam Bansal 
1   Department of Orthopedics, All India Institute of Medical Science (AIIMS) Rishikesh, Rishikesh, Uttarakhand, India
,
Vikas Maheshwari
1   Department of Orthopedics, All India Institute of Medical Science (AIIMS) Rishikesh, Rishikesh, Uttarakhand, India
,
Bishwa Bandhu Niraula 
1   Department of Orthopedics, All India Institute of Medical Science (AIIMS) Rishikesh, Rishikesh, Uttarakhand, India
,
Anil Regmi 
1   Department of Orthopedics, All India Institute of Medical Science (AIIMS) Rishikesh, Rishikesh, Uttarakhand, India
,
Kalyani Sridharan
2   Department of Endocrinology, All India Institute of Medical Science (AIIMS) Rishikesh, Rishikesh, Uttarakhand, India
,
Mohit Dhingra 
1   Department of Orthopedics, All India Institute of Medical Science (AIIMS) Rishikesh, Rishikesh, Uttarakhand, India
› Author Affiliations Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Abstract

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Shivam Bansal
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Mohit Dhingra

Background Oncogenic osteomalacia term used for tumor-induced osteomalacia (TIO) is a paraneoplastic syndrome of abnormal phosphate metabolism secondary to ectopic endocrine tumors. The diagnosis often becomes difficult due to rarity of occurrence and deficient literature. The reconstruction following resection has its own technical difficulties, which are addressed in this article.

Presentation of Case A 39-year-old female presented with pain in bilateral lower limbs and difficulty in mobilizing. The patient had unexplained hypophosphatemia which was diagnosed due to tumor (arising ectopically in greater trochanter), inducing osteomalacia. She was managed successfully with excision of tumor and reconstruction. The biochemical parameters improved drastically within 5 days and fracture healed in 6 weeks' time.

Conclusion TIO is a debilitating disease with significant morbidity due to prolonged onset to diagnosis interval and difficulty in localizing the causative tumor. So thorough clinico-radiological and laboratory parameter correlation is a necessity. A rapid diagnosis followed by complete surgical excision, which remains the gold standard treatment modality that confers favorable prognosis in most patients, with strict vigilance for recurrence is required.

Keywords

tumor-induced osteomalacia - greater trochanter reconstruction - phosphaturic mesenchymal tumor - fragility fracture - surgical technique

Authors' Contributions

S.B. – Investigation, methodology, project administration.


V.M. – Data curation, formal analysis, manuscript writing.


B.B.N. – Data collection.


A.R. – Data collection.


K.S. – Data collection, review of literature, writing – review and editing.


M.D. – Conceptualization, planning and forming the outline of study, supervision.


Informed Consent for Publication

Informed consent was obtained from the patient for publication of this case report. On request, a copy of the written consent is available for review by the Editor-in-Chief of this journal.




Publication History

Article published online:
09 June 2023

© 2023. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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