A Case Report | Open Access
Volume 2025 - 4 | Article ID 254 | http://dx.doi.org/10.51521/WJCRCI.2025.41-307
Academic Editor: John Bose
1#Varsha Kachroo, 2Chandar
Mohan Batra, 3Ameet Kishor, 4Vikas Kashyap, 5Dhruv
Mishra
1Department
of Endocrinology, Yatharth Hospital, Noida Extension, Uttar Pradesh, India. 201306
Email: varshakachroo@gmail.com
2Indraprastha
Apollo Hospitals, Delhi, India, Email: chandarbatra@yahoo.com
3Indraprastha
Apollo Hospitals, Delhi, India, Email: dr.kishore.ent@gmail.com
4Indraprastha
Apollo Hospitals, Delhi, India, Email: vikas_k@apollohospitalsdelhi.com
5Indraprastha
Apollo Hospitals, Delhi, India, Email: im_dhruv@yahoo.co.in
Corresponding Author: Varsha
Kachroo, Department of Endocrinology, Yatharth Hospital, Noida Extension, Uttar
Pradesh, India. 201306, Email: varshakachroo@gmail.com
Citation: Varsha
Kachroo, Chandar Mohan Batra, Ameet Kishor, Vikas Kashyap, Dhruv Mishra (2025) A Case Report of
Tumor Induced Osteomalacia Due to Mesenchymal Tumor in the Temporal Bone World
J Case Rep Clin Imag. 2025 March; 4(1)1-5.
Copyrights © 2025, Varsha Kachroo, et
al. This article is licensed under the Creative Commons Attribution-NonCommercial-4.0-International-License-(CCBY-NC)
(https://worldjournalofcasereports.org/blogpage/copyright-policy). Usage and
distribution for commercial purposes require written permission.
Abstract:
Tumor Induced Osteomalacia
(TIO) is a paraneoplastic syndrome characterized by renal phosphate wasting due
to excess production of fibroblast growth factor (FGF23). The average lag
period between the initial clinical manifestations and the time when patient
gets his correct diagnosis is 2.5-3 years and is due to non-specificity of
their symptoms. Hence, it is important to diagnose the condition and localize
the the tumor [1.3]. A male patient in his 40s, was referred to us
as a case of osteoporosis with clinical features suggestive of proximal
myopathy, Lower Motor Neuron (LMN) type facial palsy. On evaluation, the
laboratory results revealed hypophosphatemia on the background of normal serum
calcium levels, normal 25(OH) Vitamin D and 1,25-dihydroxy Vitamin D and
elevated serum Alkaline phosphatase levels. This led to the calculation of
TmP/gfr (Tubular maximum reabsorption rate of phosphate to glomerular filtration
rate) which was also low indicating inappropriate renal phosphate wasting. A possibility of TIO
was kept, and we were able to localise the tumor to his left temporal bone with
the help of nuclear imaging. The tumor was resected and its histopathological
examination showed benign spindle cell mesenchymal tumor consistent with a
phsophaturic mesenchymal tumor. Postoperatively, there was significant clinical
improvement and phosphate levels also returned to the normal reference range.
Hypophosphatemia with normal serum calcium levels and 25(OH) Vitamin D and
1,25-dihydroxy Vitamin D levels in adults with significant musculoskeletal
symptoms calls for the evaluation of TIO.
Keywords: Tumor Induced Osteomalacia, TIO, Hypophostemic
Osteomalacia, Mesenchymal Tumor, Case Report
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