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Metastatic prostate cancer presenting as tumour-induced osteomalacia
  1. Awo Akosua K Layman1,
  2. Shivam Joshi2 and
  3. Sanjeev Shah3,4
  1. 1 Perelman School of Medicine, Medical Scientist Training Program, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  2. 2 Internal Medicine, New York University, New York, New York, USA
  3. 3 Renal, Electrolyte, and Hypertension Division, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  4. 4 Medicine, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Sanjeev Shah, sanjeev.shah{at}


Tumour-induced osteomalacia (TIO), or oncogenic osteomalacia, is a paraneoplastic syndrome marked by hypophosphataemia, renal phosphate wasting, bone pain, weakness, and fractures. The syndrome has been reported with both benign and malignant tumours including parotid gland basal cell tumours, thyroid carcinomas, colon adenocarcinomas, and prostate cancer. Often, the syndrome is marked by an insidious course during which patients present with generalised bony pain and weakness, which do not resolve until the underlying tumour is identified and treated. We present a case of a patient with Parkinson’s disease whose subacute weakness, lower extremity paresis, and renal phosphate wasting led to the synchronous diagnosis of metastatic prostate adenocarcinoma and TIO.

  • prostate
  • calcium and bone

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  • Contributors AAKL wrote the article with revisions from SJ and SS. All three authors were involved in providing care for the patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Next of kin consent.

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