Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by ectopic fibroblast growth factor-23 (FGF23) production. We report a unique case of a 78-year-old female patient with refractory hypophosphatemia. ultimately diagnosed as TIO. in the context of two metastatic primary lung cancers: adenocarcinoma and SCLC. https://www.lightemupsequences.com/mega-save-Zelda-Link-to-the-Past-Player-s-Choice-Super-Nintendo-Used-Fair-Condition-p15874-save-extra