Clinical Features of Pediatric Tumor-Induced Osteomalacia: A Comprehensive Review and Analysis of Individual Patient Data

By
Rong Chen
Zhangxin Wen
Cheng Cheng
Xinping Li
Jingyi Wang
Hong Liu
Hailing Chen
July 21, 2026

Frontiers In Endocrinology

Overview

This comprehensive review analyzes 62 pediatric cases of tumor-induced osteomalacia (TIO), highlighting its prevalence in males and the diagnostic challenges associated with this condition.

Background

Pediatric tumor-induced osteomalacia (TIO) is a rare condition characterized by renal phosphate wasting and hypophosphatemia, leading to rickets. It is crucial to identify and localize the tumors responsible for TIO early to prevent irreversible skeletal deformities and growth impairment.

Data Highlights

Characteristic	Findings
Total Cases	62
Male Prevalence	More frequent in males
Misdiagnosis Rate	16.1%
Resolution Rate Post-Surgery	84.2%

Key Findings

Pediatric TIO is more common in males, who show higher rates of weakness and deformities.
16.1% of patients were misdiagnosed with other conditions.
Most tumors are benign and located in the lower extremities.

Clinical Implications

Clinicians should consider TIO in pediatric patients presenting with hypophosphatemia to avoid misdiagnosis.

Conclusion

Pediatric TIO predominantly affects males and is often misdiagnosed.

Clinical Features of Pediatric Tumor-Induced Osteomalacia: A Comprehensive Review and Analysis of Individual Patient Data