{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:10:03Z","timestamp":1756275003109,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,4,29]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Tumour-induced osteomalacia (TIO) is a rare cause of acquired hypophosphataemia most often due to paraneoplastic overproduction of fibroblast growth factor-23 (FGF-23). A woman in her 60s presented with an 18\u2009month history of insidious back, knee and ankle pain, and progressive weakness. Biochemistry revealed low serum phosphate and a bone scan showed diffuse bony lesions, initially suspected to be metastatic sarcoma given her history of uterine sarcoma. However, a positron emission tomography scan identified a solitary destructive lytic lesion in the right posterior second rib. Endocrine workup showed low serum phosphate, high fractional excretion of phosphate, normal 25-hydroxyvitamin D and elevated FGF-23 levels. A biopsy revealed spindle cell neoplasm, which later stained positive for FGF receptor 1, consistent with renal phosphate wasting secondary to TIO. The patient was started on burosumab, a human monoclonal antibody against FGF-23, which normalised her serum phosphate and led to marked clinical improvement. She is now awaiting curative surgery for the primary rib lesion.<\/jats:p>","DOI":"10.1136\/bcr-2025-265058","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T23:45:23Z","timestamp":1747352723000},"page":"e265058","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Burosumab treatment of tumour-induced osteomalacia from a rib lesion"],"prefix":"10.1136","volume":"18","author":[{"given":"Claire","family":"Song","sequence":"first","affiliation":[{"name":"University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Radiology, University of Calgary Cumming School of Medicine, Calgary, Alberta, 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