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Updated: Aug 1, 2025
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Lower Limb Biomechanical Analysis of Healthy Participants
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The Right Leg that Troubled the Left Leg
The Journal of the Association of Physicians of India
|April 28, 2023
Summary
Oncogenic osteomalacia, a rare condition causing defective bone mineralization due to FGF-23, was successfully treated by surgically removing a mesenchymal tumor. This case highlights the importance of prompt diagnosis and treatment for improved patient outcomes.
Area of Science:
- Endocrinology
- Oncology
- Bone Metabolism
Background:
- Oncogenic osteomalacia (TIO) is a rare paraneoplastic syndrome.
- It involves defective bone mineralization caused by Fibroblast Growth Factor-23 (FGF-23).
- FGF-23 is released from small mesenchymal tumors.
Observation:
- A 31-year-old female presented with leg pain and difficulty walking.
- Initial workup revealed elevated alkaline phosphatase, pseudo fractures, and isolated hypophosphatemia.
- Further investigations showed low Tmp-GFR and high FGF23 levels.
Findings:
- A whole-body PET scan identified a mesenchymal tumor in the right lower limb.
- Surgical removal of the tumor led to symptom resolution.
- This confirmed the diagnosis of oncogenic osteomalacia.
Implications:
- Oncogenic osteomalacia is a rare cause of renal phosphate wasting and severe hypophosphatemia.
- Surgical tumor removal offers an excellent prognosis with dramatic improvement.
- Early diagnosis through high suspicion and prompt investigation improves patient outcomes.
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