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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
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Updated: May 27, 2025

Osteoclast Derivation from Mouse Bone Marrow
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Tumour-induced osteomalacia.

Athira Ramakrishanan1, Aashish Parekh2, Shankarmurthy Gayana2

  • 1Department of Head and Neck Surgical Oncology, Fortis Hospital, Bannerghatta Road, Bengaluru 560076, Karnataka, India.

The National Medical Journal of India
|February 15, 2025
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Tumour-induced osteomalacia (TIO), a rare condition, involves tumors secreting fibroblast growth factor 23 (FGF-23). Early diagnosis and surgical removal of these phosphaturic tumors are crucial for patient recovery and managing bone disease.

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Area of Science:

  • Endocrinology
  • Oncology
  • Orthopedics

Background:

  • Tumour-induced osteomalacia (TIO) is a rare paraneoplastic syndrome.
  • It is characterized by elevated levels of fibroblast growth factor 23 (FGF-23).
  • FGF-23 dysregulation leads to renal phosphate wasting and impaired bone mineralization.

Observation:

  • A 45-year-old male presented with profound weakness and recurrent fractures.
  • Elevated FGF-23 levels were detected.
  • DOTATATE PET scan identified a tumor in the ethmoid and sphenoid sinuses.

Findings:

  • The patient underwent successful endoscopic sinus surgery for tumor excision.
  • Histopathology confirmed a phosphaturic mesenchymal tumor.
  • Post-surgery, serum phosphorus normalized, and clinical symptoms significantly improved within a month.

Implications:

  • This case highlights the importance of timely diagnosis and surgical intervention for TIO.
  • Prompt management can reverse the debilitating effects of FGF-23 overproduction.
  • Further research into early detection methods for TIO is warranted.