Tumour induced osteomalacia

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 due to 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.