{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:30:00Z","timestamp":1787121000649,"version":"build-2736575974"},"reference-count":23,"publisher":"Journal of the ASEAN Federation of Endocrine Societies (JAFES)","issue":"2","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J ASEAN Fed Endocr Soc"],"abstract":"<jats:p>Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by fibroblast growth factor 23 (FGF23)\u00a0 secreting\u00a0 phosphaturic mesenchymal tumors. We report a 53-year-old man with progressive osteomalacia resulting in bedridden status. Renal phosphate wasting despite normal vitamin D, intact parathormone, and renal function raised suspicion of TIO, confirmed by elevated FGF23. However, the occult tumor was localized only by Ga-68 DOTANOC wholebody PET-CT, highlighting the diagnostic challenges in TIO.<\/jats:p>","DOI":"10.15605\/jafes.041.02.5185","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:04:13Z","timestamp":1787119453000},"source":"Crossref","is-referenced-by-count":0,"title":["Phosphaturic Mesenchymal Tumor"],"prefix":"10.15605","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9097-0343","authenticated-orcid":false,"given":"Ramita","family":"Mukherjee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1208-1349","authenticated-orcid":false,"given":"Santosha","family":"Kumar Pattashanee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9183-2317","authenticated-orcid":false,"given":"Brijesh Kumar","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1214-0014","authenticated-orcid":false,"given":"Asuri","family":"Krishna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7853-1168","authenticated-orcid":false,"given":"Sushant","family":"Soren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A Nishikant","family":"Damle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M C","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5631-0671","authenticated-orcid":false,"given":"V","family":"Seenu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6244","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"86732","doi-asserted-by":"crossref","unstructured":"1. 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Semin Diagn Pathol. 2019;36(4):260-8. https:\/\/pubmed.ncbi.nlm.nih.gov\/31301876 https:\/\/doi.org\/10.1053\/j.semdp.2019.07.002","DOI":"10.1053\/j.semdp.2019.07.002"},{"key":"86735","doi-asserted-by":"crossref","unstructured":"4. Evans DJ, Azzopardi JG. Distinctive tumours of bone and soft tissue causing acquired vitamin-D-resistant osteomalacia. Lancet. 1972;1(7746):353-4. https:\/\/pubmed.ncbi.nlm.nih.gov\/4109739 https:\/\/doi.org\/10.1016\/s0140-6736(72)92844-9","DOI":"10.1016\/S0140-6736(72)92844-9"},{"key":"86736","doi-asserted-by":"crossref","unstructured":"5. Abrahamsen B, Smith CD, Minisola S. Epidemiology of tumor-induced osteomalacia in Denmark. Calcif Tissue Int. 2021;109(2):147-56. https:\/\/pubmed.ncbi.nlm.nih.gov\/33818653 https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8273058 https:\/\/doi.org\/10.1007\/s00223-021-00843-2","DOI":"10.1007\/s00223-021-00843-2"},{"key":"86737","doi-asserted-by":"crossref","unstructured":"6. Yin Z, Du J, Yu F, Xia W. Tumor-induced osteomalacia. Osteoporos Sarcopenia. 2018;4(4):119-27. https:\/\/pubmed.ncbi.nlm.nih.gov\/30775554 https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6372818 https:\/\/doi.org\/10.1016\/j.afos.2018.12.001","DOI":"10.1016\/j.afos.2018.12.001"},{"key":"86738","doi-asserted-by":"crossref","unstructured":"7. Urakawa I, Yamazaki Y, Shimada T, et al. Klotho converts canonical FGF receptor into a specific receptor for FGF23. Nature. 2006;444(7120):770-4. https:\/\/pubmed.ncbi.nlm.nih.gov\/17086194 https:\/\/doi.org\/10.1038\/nature05315","DOI":"10.1038\/nature05315"},{"key":"86739","doi-asserted-by":"crossref","unstructured":"8. Shimada T, Hasegawa H, Yamazaki Y, et al. FGF-23 is a potent regulator of vitamin D metabolism and phosphate homeostasis. J Bone Miner Res. 2004;19(3):429-35. https:\/\/pubmed.ncbi.nlm.nih.gov\/15040831 https:\/\/doi.org\/10.1359\/JBMR.0301264","DOI":"10.1359\/JBMR.0301264"},{"key":"86740","doi-asserted-by":"crossref","unstructured":"9. Ackah SA, Imel EA. Approach to hypophosphatemic rickets. J Clin Endocrinol Metab. 2022;108(1):209-20. https:\/\/pubmed.ncbi.nlm.nih.gov\/35981346 https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9759174 https:\/\/doi.org\/10.1210\/clinem\/dgac488","DOI":"10.1210\/clinem\/dgac488"},{"key":"86741","doi-asserted-by":"crossref","unstructured":"10. Hacisahinogullari H, Tekin S, Tanrikulu S, et al. Diagnosis and management of tumor-induced osteomalacia: A single center experience. Endocrine. 2023;82(2):427-34. https:\/\/pubmed.ncbi.nlm.nih.gov\/37480497 https:\/\/doi.org\/10.1007\/s12020-023-03450-3","DOI":"10.1007\/s12020-023-03450-3"},{"key":"86742","doi-asserted-by":"crossref","unstructured":"11. Lee JC, Jeng YM, Su SY, et al. Identification of a novel FN1-FGFR1 genetic fusion as a frequent event in phosphaturic mesenchymal tumour. J Pathol. 2015;235(4):539-45. https:\/\/pubmed.ncbi.nlm.nih.gov\/25319834 https:\/\/doi.org\/10.1002\/path.4465. 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AJNR Am J Neuroradiol. 2022;43(6):817-22. https:\/\/pubmed.ncbi.nlm.nih.gov\/35589138 PMCID: PMC9172954 https:\/\/doi.org\/10.3174\/ajnr.A7513","DOI":"10.3174\/ajnr.A7513"},{"key":"86746","doi-asserted-by":"crossref","unstructured":"15. Agaimy A, Michal M, Chiosea S, et al. Phosphaturic mesenchymal tumors: Clinicopathologic, immunohistochemical and molecular analysis of 22 cases expanding their morphologic and immunophenotypic spectrum. Am J Surg Pathol. 2017;41(10):1371-80. https:\/\/pubmed.ncbi.nlm.nih.gov\/28614212 https:\/\/doi.org\/10.1097\/PAS.0000000000000890","DOI":"10.1097\/PAS.0000000000000890"},{"key":"86747","doi-asserted-by":"crossref","unstructured":"16. \u00c1lvarez-Rivas N, Lugo-Rodr\u00edguez G, Maneiro JR, et al. Tumor-induced osteomalacia: A systematic literature review. Bone Rep. 2024;21:101772. https:\/\/pubmed.ncbi.nlm.nih.gov\/38774264 PMCID: PMC11107251 https:\/\/doi.org\/10.1016\/j.bonr.2024.101772","DOI":"10.1016\/j.bonr.2024.101772"},{"key":"86748","doi-asserted-by":"crossref","unstructured":"17. Rendina D, Abate V, Cacace G, et al. Tumor-induced osteomalacia: A systematic review and individual patient's data analysis. J Clin Endocrinol Metab. 2022;107(8):e3428-36. https:\/\/pubmed.ncbi.nlm.nih.gov\/35468192 https:\/\/doi.org\/10.1210\/clinem\/dgac253","DOI":"10.1210\/clinem\/dgac253"},{"key":"86749","doi-asserted-by":"crossref","unstructured":"18. Minisola S, Peacock M, Fukumoto S, et al. Tumour-induced osteomalacia. Nat Rev Dis Primers. 2017;3:17044. https:\/\/pubmed.ncbi.nlm.nih.gov\/28703220 https:\/\/doi.org\/10.1038\/nrdp.2017.44","DOI":"10.1038\/nrdp.2017.44"},{"key":"86750","doi-asserted-by":"crossref","unstructured":"19. Jan de Beur SM, Miller PD, Weber TJ, et al. Burosumab for the treatment of tumor-induced osteomalacia. J Bone Miner Res. 2021;36(4):627-35. https:\/\/pubmed.ncbi.nlm.nih.gov\/33338281 PMCID: PMC8247961 https:\/\/doi.org\/10.1002\/jbmr.4233","DOI":"10.1002\/jbmr.4233"},{"key":"86751","doi-asserted-by":"crossref","unstructured":"20. Jiang Y, Li X, Huo L, et al; Chinese Society of Osteoporosis and Bone Mineral Research and Chinese Society of Endocrinology. Consensus on clinical management of tumor-induced osteomalacia. Chin Med J (Engl). 2021;134(11):1264-6. https:\/\/pubmed.ncbi.nlm.nih.gov\/33813513 PMCID: PMC8183716 https:\/\/doi.org\/10.1097\/CM9.0000000000001448","DOI":"10.1097\/CM9.0000000000001448"},{"key":"86752","doi-asserted-by":"crossref","unstructured":"21. Shi X, Jing H, Li F, Zhao Y, Wang Z, Huo L. 99mTc-HYNIC-TOC in the evaluation of recurrent tumor-induced osteomalacia. Clin Nucl Med. 2019;44(3):209-13. https:\/\/pubmed.ncbi.nlm.nih.gov\/30672760 https:\/\/doi.org\/10.1097\/RLU.0000000000002458","DOI":"10.1097\/RLU.0000000000002458"},{"key":"86753","doi-asserted-by":"crossref","unstructured":"22. Dahir K, Zanchetta MB, Stanciu I, et al. Diagnosis and management of tumor-induced osteomalacia: Perspectives from clinical experience. J Endocr Soc. 2021;5(9):bvab099. https:\/\/pubmed.ncbi.nlm.nih.gov\/34286168 https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8282217 https:\/\/doi.org\/10.1210\/jendso\/bvab099","DOI":"10.1210\/jendso\/bvab099"},{"key":"86754","doi-asserted-by":"crossref","unstructured":"23. Ito N, Shimizu Y, Suzuki H, et al. Clinical utility of systemic venous sampling of FGF23 for identifying tumours responsible for tumour-induced osteomalacia. 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