Tumor-Induced Osteomalacia

  • Mark Anthony SandovalEmail author


Tumor-induced osteomalacia is an acquired paraneoplastic disease of the bone that occurs due to oversecretion of the phosphaturic hormone FGF23 by a functioning tumor. Clinical features are similar to other causes of osteomalacia such as bone pains, bone deformities, and bone weakness. The underlying causative tumor is usually asymptomatic. Laboratory hallmarks are hypophosphatemia, phosphaturia, and low 1,25 dihydroxy vitamin D. The causative tumor must be located by a combination of physical examination and functional and anatomical imaging tests. Cure is possible and prognosis is favorable when the causative tumor is completely excised. When surgery is not possible or carries significant postoperative morbidity, a variety of pharmacologic agents and tumor-directed therapies can be employed.


Tumor-induced osteomalacia Oncogenic osteomalacia Paraneoplastic syndrome Phosphatonin Fibroblast growth factor 23 



Computed tomography


1,4,7,10-Tetraazacyclododecane -D-Phe1-1-Nal3-octreotide


1,4,7,10-Tetraazacyclododecane-1,4,7,10-tetraacetic acid octreotate


1,4,7,10-Tetraazacyclododecane-N,N,N,N-tetraacetic-acid-D-Phe1 -Tyr3 –octreotide




Fibroblast growth factor




Matrix extracellular phosphoglycoprotein




Magnetic resonance imaging


Sodium-phosphate cotransporter


Oncogenic osteomalacia


Positron emission tomography


Phosphaturic mesenchymal tumor


Phosphaturic mesenchymal tumor, mixed connective tissue variant


Secreted frizzled-related protein 4


Single photon emission computed tomography


Tumor-induced osteomalacia


Tubular maximum reabsorption of phosphate corrected for glomerular filtration rate


Tubular phosphate reabsorption


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Physiology and Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Philippine General HospitalUniversity of the Philippines ManilaManilaPhilippines

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