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Pathophysiology of tumor-induced osteomalacia

Legend: 1,25(OH)2D, 1,25-dihydroxyvitamin D; FGF23, fibroblast growth factor 23; NPT2, type II sodium phosphate cotransporter; PMT, phosphaturic mesenchymal tumor. (Source: Jan de Beur SM, Minisola S, Xia WB, et al. Global guidance for the recognition, diagnosis, and management of tumor-induced osteomalacia. J Intern Med 2023;293[3]:309-28.)

Figure adapted from:
Minisola S, Peacock M, Fukumoto S, et al. Tumour-induced osteomalacia. Nat Rev Dis Primers 2017;3:17044.
Courbebaisse M, Lanske B. Biology of fibroblast growth factor 23: from physiology to pathology. Cold Spring Harb Perspect Med 2018;8[5]:a031260.
Saraff V, Nadar R, Högler W. New Developments in the treatment of X-linked hypophosphataemia: implications for clinical management. Paediatr Drugs 2020;22[2]:113-21. Creative Commons Attribution [CC-BY] license,

Associated Disorders

  • Calciphylaxis
  • Chronic renal failure
  • DiGeorge Syndrome
  • Hemochromatosis
  • Osteitis fibrosa cystica
  • Osteomalacia
  • Parathyroid adenocarcinoma
  • Parathyroid adenoma
  • Wilson disease