title: Tumour induced osteomalacia.
abstract: Tumour-induced osteomalacia (TIO) is a rare paraneoplastic syndrome usually presenting with bone pain, fracture of bones and muscle weakness. It is caused by high serum levels of fibroblast growth factor 23 (FGF- 23), which is a hormone-regulating phosphate, and vitamin D. FGF-23 is secreted by several tumours, especially benign mesenchymal tumours which are very small and difficult to locate. There is a significant delay from onset of symptoms to the diagnosis of this entity dueto occult nature of this disease. We present a case of young male who presented with long history of progressively worsening muscular pain and weakness, rendering the patient confined to bed. Our aim of presenting this patient as a case report is to make physicians realise that any patient with unexplained muscular weakness and pain must undergo workup for TIO, including serum phosphate measurement, as this is a rare but potentially curable disease.
authors.forename: Muhammad Qamar
authors.initials: MQ
authors.lastname: Masood
authors.forename: Nanik
authors.initials: N
authors.lastname: Ram
authors.forename: Syed Ahsan
authors.initials: SA
authors.lastname: Ali
mesh_terms: D000328:Adult; D000089703:Fibroblast Growth Factor-23; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D009372:Neoplasms, Connective Tissue / Q000150:complications* / Q000209:etiology; D010018:Osteomalacia; D010257:Paraneoplastic Syndromes / Q000209:etiology*; D011877:Radionuclide Imaging; D012983:Soft Tissue Neoplasms / Q000150:complications*