Publication:

Tumour induced osteomalacia: a diagnostic challenge and its implications in orthopaedic surgery

Tumor-induced osteomalacia (TIO) is a paraneoplastic phenomenon which encompasses a wide array of clinical features ranging from musculoskeletal pain to pathological fractures. An excess of fibroblast growth factor 23 (FGF23) is produced which is a parahormone with its target receptors in proximal convoluted tubules of glomeruli. This results in decreased blood phosphate levels and decreased hydroxylation of 25-OH vitamin-D, ultimately leading to osteomalacia. Compliance with medical treatment is unsatisfactory and tedious owing to repeated dosing schedules and overwhelming side effects. Surgical excision of the lesion is the only suitable treatment.