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Tumor-induced osteomalacia (TIO): atypical presentation
Waseem Khaliq1, Praveen Cheripalli, Krishnarao Tangella
1Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA. khaliqmd@gmail.com
Southern Medical Journal
|May 25, 2011
Summary
Tumor-induced osteomalacia, a rare disorder causing bone softening, presented unusually in a teen with respiratory symptoms. Surgical removal of a chest mass resolved the condition, highlighting diagnostic challenges.
Area of Science:
- Oncology
- Endocrinology
- Pathology
Background:
- Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome.
- It is characterized by renal phosphaturia and hypophosphatemia, leading to osteomalacia.
- TIO typically presents with bone pain and muscle weakness.
Observation:
- A 15-year-old male presented with cough and chest pain.
- Imaging revealed a mass in the extrapleural space.
- Histopathology showed a chondro-myxoid stroma with osteoid formation.
Findings:
- The patient was diagnosed with TIO based on clinical presentation, imaging, and biochemical findings (hypophosphatemia).
- The mass was identified as the source of phosphaturic activity.
- Surgical excision of the mass led to complete resolution of symptoms.
Implications:
- This case underscores the importance of considering TIO in patients with unexplained hypophosphatemia, even with atypical presentations.
- Early diagnosis and surgical management are crucial for favorable outcomes.
- Rare tumors can manifest with diverse clinical symptoms, posing diagnostic challenges.
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