Radiofrequency ablation in tumour-induced osteomalacia: a therapeutic challenge

Tumour-induced osteomalacia (TIO) is an uncommon, debilitating disorder often characterised by non-specific clinical manifestations, posing a significant diagnostic challenge. The tumours causing TIO can be minuscule and occur in unusual areas, further complicating diagnosis. This report details the case of a woman in her early 30s presenting with chronic pain who subsequently developed fragility fractures. The evaluation revealed hypophosphataemia with evidence of renal phosphate wasting demonstrated by a low ratio of tubular maximum reabsorption of phosphate to the glomerular filtration rate for her age. Ga-68 DOTANOC positron emission tomography/CT successfully localised the fibroblast growth factor-23-secreting tumour at the lower table of the mandible close to the mentum. Given the overall general health condition of the patient, radiofrequency ablation (RFA), a minimally invasive approach, was performed despite surgical resection remaining the traditional gold standard treatment. Following RFA, the patient reported significant symptomatic improvement and regained mobility through rehabilitative measures.