Doctors here have successfully treated a 41-year-old man with an extremely rare tumour-induced condition that caused bone fragility, fractures and left him wheelchair-bound.

Tumour-induced osteomalacia is an extremely rare disorder where benign small soft tissue or bone tumours develop in the body and start secreting a substance that inhibits the absorption of phosphates, causing a cascade of biochemical abnormalities including extremely fragile bones.

 

"So rare is this condition that many doctors fail to get to the root of it. A majority of these tumours are located in the extremities (skin, muscles, and bones) or around the head, but they may occur in almost any part of the body. These tumours are slow growing and often remain hidden or undetected until clinical features reach a fairly advanced stage," Endocrinologist at Venkateshwar Hospital in Dwarka Deep Dutta said in a statement on Saturday.

Progressive weakness in legs over three years coupled with a fracture had left Ravi Sharma (name changed) wheelchair-bound. Doctors found that he had extremely low serum levels of phosphorus (1mg/dl) -- key structural component of bone apart from calcium -- in urine, which led to skeletal weakness and fractures. An FDG (fluorodeoxyglucose)-PET scan confirmed the presence of tumour-induced osteomalacia at the lower end of the femur bone and later a CT-scan revealed an extremely small lesion of 1 cm diameter, and was successfully removed by the doctors.

"Within 24 hours of surgery, we found the patient's phosphorus levels improved to 3.3mg/dl, and he regained his physical strength and was able to start walking with support. We have reduced Ravi's oral phosphate replacement dose significantly and we expect he will be totally off phosphate replacement in the next few days. All biochemical and clinical features reverted to normal when the tumour was removed," Dutta said.