Functional and Anatomical Imaging for Early Diagnosis of Tumor Induced Osteomalacia

Oncogenic osteomalacia, or tumor-induced osteomalacia (TIO), is an acquired paraneoplastic syndrome being associated with benign or in rare cases malignant mesenchymal. Patients with TIO often present with many years of nonspecific but progressive symptoms commonly with bone pain, muscle weakness, reduced height, and multiple fractures. Due to this nonspecificity, patients are often misdiagnosed with a variety of musculoskeletal, rheumatologic diseases and sometimes even having psychiatric disorders. Not only that these tumors are rare but also finding the tumor can be a major diagnostic challenge and may need total body magnetic resonance imaging, computed tomography and scintigraphy using radio labelled somatostatin analogue and sometimes even venous sampling. Majority of clinicians, radiologists and pathologists are not aware of this rare disease because mostly the cases are described in rheumatology practice. We provide mini review of the current literature by having looked at the different studies done including case reports to conclude the best practice for the diagnosis and treatment of this rare entity.