CASE REPORT article
Front. Endocrinol.
Sec. Bone Research
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1655376
This article is part of the Research TopicBone Metastases in Endocrine Cancers: Advances in Diagnosis, Treatment, and PreventionView all 4 articles
Case Report with Literature Review: Tumor-Induced Osteomalacia from a Soft-Tissue Phosphaturic Mesenchymal Tumor of the Trunk
Provisionally accepted
- 1Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
- 2Guangzhou University of Chinese Medicine, Guangzhou, China
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Background: Tumor-induced osteomalacia (TIO), a type of acquired hypophosphatemic osteomalacia, is brought on by tumors producing excessive levels of fibroblast growth factor 23, which raises renal phosphorus excretion. Methods: Through a review of the literature, we have outlined the clinical characteristics of 33 patients with soft-tissue TIO of the trunk and described a case of TIO brought on by a soft-tissue tumor on the back. Results: A 63-year-old woman who had been experiencing generalized bone pain for approximately three years visited the hospital. Physical examination revealed a round mass on the back measuring approximately 2 × 2 cm. Laboratory tests showed low blood phosphorus, elevated synchronous urinary phosphorus, and elevated alkaline phosphatase levels. The mass was detected using magnetic resonance imaging and ultrasound, and it was subsequently surgically excised. Following surgery, phosphate levels returned to normal, bone pain was relieved, and pathology confirmed phosphaturic mesenchymal tumor (PMT). A literature review identified only 33 cases of soft-tissue TIO occurring in the trunk, with a mean age of 49.7 ± 15.6 years and a male-to-female ratio of 23:10. Bone pain was present in 91% of patients, and diagnostic delay of more than two years was observed in 72.4% of cases. The mean preoperative serum phosphorus level was 0.48 ± 0.137 mmol/L, and the median tumor size was 3 cm (IQR: 2-4.65 cm). Postoperative remission of biochemical indices and clinical symptoms was observed in 96.9% of patients, with no recurrence during the follow-up period. The majority of tumors (72.7%) were pathologically diagnosed as PMT. Conclusion: Soft-tissue TIO of the trunk is rare. Clinicians should be alert to the possibility of TIO in patients with unexplained bone pain and hypophosphatemia and should promptly perform appropriate examinations to avoid missed diagnoses.
Keywords: Tumor-induced osteomalacia, Phosphaturic mesenchymal tumor, Hypophosphatemia, Soft-tissue, trunk
Received: 27 Jun 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Tao, Deng, Chen, Wang, Zhou and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yu-qing Zhou, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
Yue Wu, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
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