title: Tumor-Induced Osteomalacia: an Up-to-Date Review.
abstract: Tumor-induced osteomalacia (TIO) is a paraneoplastic syndrome resulting in renal phosphate wasting and decreased bone mineralization. TIO is usually induced by small, slowly growing tumors of mesenchymal origin (phosphaturic mesenchymal tumor mixed connective tissue variant [PMTMCT]). Nonspecific symptoms including fatigue, bone pain, and musculoskeletal weakness make the diagnosis elusive and often lead to a delay in treatment. The prognosis of TIO is excellent following complete resection of the neoplasm, which leads to the rapid and complete reversal of all symptoms. If the tumor cannot be detected, treatment relies on supplementation with phosphate and active vitamin D compounds. Subsequent radiotherapy in case of incompletely resected tumors or definitive radiotherapy in unresectable tumors is an important treatment option to avoid recurrence or metastasis even though this occurs rarely. Due to the risk of recurrence or late metastases, long-term monitoring is required even in TIO patients diagnosed with a benign tumor.
authors.affiliation: Department of Internal Medicine III (Hematology and Oncology), University Medical Center of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany, anke.hautmann@ukr.de.
authors.forename: Anke H
authors.initials: AH
authors.lastname: Hautmann
authors.forename: Matthias G
authors.initials: MG
authors.lastname: Hautmann
authors.forename: Oliver
authors.initials: O
authors.lastname: Kölbl
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Herr
authors.forename: Martin
authors.initials: M
authors.lastname: Fleck
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D008637:Mesenchymoma / Q000150:complications / Q000628:therapy; D009372:Neoplasms, Connective Tissue / Q000150:complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D010018:Osteomalacia; D010257:Paraneoplastic Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011379:Prognosis