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TIO: The Bone-Breaking Tumor


RALEIGH, N.C. – A young North Carolina high school teacher went from doctor to doctor and diagnosis to diagnosis to find out why his bones were breaking but left with more pain than answers.

Two years ago, David Covington didn’t think his back pain and general weakness would turn into him needing a cane at 27. He even had a hard time with household chores.

“I couldn’t get the lawn mower started and it was just a pull and I wasn’t strong enough to pull it on,” Covington said.

Doctors did a full body scan on Covington and found he had several stress fractures throughout his body.

“That was kind of where I really felt that ‘Oh maybe this is something more serious than just back pain,’” Covington said.

After two orthopedists, a rheumatologist and months of treatments, Covington’s condition worsened, and he became so weak that he was falling. An endocrinologist at Vanderbilt University said a tumor in his brain may be the culprit.

“A rare problem called TIO, which stands for tumor-induced osteomalacia, so tumors (were) causing breakdown of bone,” said Dr. Reid Thompson, professor of neurological surgery at Vanderbilt University Medical Center.

Covington was referred to neurosurgeon Thompson, who at first thought it was a benign tumor.

“If you ask most neurosurgeons who specialize in brain tumors what it is that you have, they would say it’s a benign tumor, nothing to worry about,” Thompson said.

But a quick search about TIO changed his mind.

“We really had to do that operation, because it was a chance to actually cure him of this disease which was ravishing his body,” Thompson said.

After the surgery and about a month of physical therapy, Covington felt normal.

“It would take about five minutes to get from my car to the front door. Now it takes about 15 seconds,” Covington said.

And two months after surgery, Covington was back in his classroom teaching, pain-free.

Doctors said Covington’s case of TIO was even more rare because of its location. Most of those tumors are normally found in the hands, feet or nasal cavities.