Tumor-induced osteomalacia (oncogenic osteomalacia) is a paraneoplastic syndrome with acquired osteomalacia secondary to abnormal urine wastage of phosphorus.
Clinical features:
(1) progressive muscle and bone pain
(2) muscle weakness
(3) fatigue
(4) recurrent fractures
Additional features seen in affected children:
(1) skeletal deformities
(2) growth retardation
(3) disordered gait
Laboratory findings:
(1) renal phosphate wasting with phosphaturia
(2) hypophosphatemia
Affected patients have a benign or malignant mesenchymal tumor which may be occult. Tumors can be localized using somatostatin receptor imaging. Removal of the tumor results in correction of the clinical and biochemical features.
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