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Diagnostic Challenges in Oncogenic Osteomalacia due to Intracranial Phosphaturic Mesenchymal Tumor: A Case Report
Singanallur Palanivelayutham Sivakumar1, Venkatesan Senthil Kannan1, Shyam Duvuru2
1Department of Orthopaedics and Trauma Surgery, Ganga Medical Centre and Hospital , Coimbatore, Tamil Nadu, India.
Case:
A 37-year-old man presented with multiple fragility fractures and profound weakness. Evaluation revealed hypophosphatemia and an elevated serum fibroblast growth factor-23. A Ga-68 DOTANOC PET-CT localized a phosphaturic mesenchymal tumor in the sphenoid bone. Surgical resection was performed with immunohistochemistry confirming the diagnosis and leading to rapid biochemical normalization. The patient showed progressive fracture healing and made a complete functional recovery by 12 months.
Conclusion:
Intracranial phosphaturic mesenchymal tumors are a rare cause of tumor-induced osteomalacia. This case underscores that in patients with unexplained fractures, systematic serum phosphate testing is critical. Functional imaging is essential for tumor localization, and complete surgical excision is curative.
