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Phosphaturic Mesenchymal Tumor: From Invisibility to Bedridden Morbidity

Ramita Mukherjee¹, Santosha Kumar Pattashanee¹, Brijesh Kumar Singh¹

¹Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.

Journal of the ASEAN Federation of Endocrine Societies

|September 28, 2026

Abstract:

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by fibroblast growth factor 23 (FGF23) secreting phosphaturic mesenchymal tumors. We report a 53-year-old man with progressive osteomalacia resulting in bedridden status. Renal phosphate wasting despite normal vitamin D, intact parathormone, and renal function raised suspicion of TIO, confirmed by elevated FGF23. However, the occult tumor was localized only by Ga-68 DOTANOC wholebody PET-CT, highlighting the diagnostic challenges in TIO.

Keywords:

FGF23 hypophosphatemia oncogenic osteomalacia paraneoplastic syndrome phosphaturic mesenchymal tumor

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