{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T10:15:36Z","timestamp":1756462536548,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,5,3]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>Tumour-induced osteomalacia (TIO), also known as oncogenic osteomalacia, is an uncommon paraneoplastic syndrome which poses a diagnostic challenge. The hallmark feature is severe acquired hypophosphataemic osteomalacia due to renal phosphate wasting because of increased secretion of fibroblast growth factor 23 (FGF-23). A man in his 30s, presented with a 4-year history of severe muscle aches, bone pain and proximal muscle weakness, was referred for evaluation. His laboratory examination revealed severe hypophosphataemia as a result of urinary phosphate wasting, low 1,25-dihydroxyvitamin D, high alkaline phosphatase and elevated FGF-23. We could localise the tumour to his right femur and the biopsy showed a mesenchymal origin. The treatment with pharmacotherapy and radiofrequency ablation helped in the normalisation of blood chemistry and resulted in significant clinical improvement. Hypophosphataemia, phosphaturia, elevated FGF-23 and low 1,25-dihydroxyvitamin D level with severe musculoskeletal pain and muscle weakness necessitate careful evaluation of TIO.<\/jats:p>","DOI":"10.1136\/bcr-2022-249200","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T11:50:44Z","timestamp":1652961044000},"page":"e249200","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Challenging case of tumour-induced osteomalacia"],"prefix":"10.1136","volume":"15","author":[{"given":"Piyush","family":"Kumar","sequence":"first","affiliation":[{"name":"Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dnyaneshwar V","family":"Jadhav","sequence":"additional","affiliation":[{"name":"Neurology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, 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