Oncogenic Osteomalacia Caused by a Phosphaturic Mesenchymal Tumor of the Mandible: a Case Report

Background: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome, and patients present with hypophosphatemia and osteomalacia, with clinical features that include bone pain, fractures, and muscle weakness. The etiology includes high levels of phosphate, vitamin D–regulating hormone, and fibroblast growth factor 23 (FGF23). In TIO, FGF23 can be secreted by a variety of tumors, most commonly mesenchymal tumors that are typically small and difficult to locate. FGF23 acts primarily at the renal tubules and impairs phosphate resorption, leading to hypophosphatemia that inhibits the 1-alpha hydroxylase.

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