Phosphaturic mesenchymal tumor: two cases highlighting differences in clinical and radiologic presentation

Phosphaturic mesenchymal tumors are rare, usually benign neoplasms that occur in the soft tissue or bone and are the cause of nearly all cases of tumor-induced osteomalacia. Tumor-induced osteomalacia due to phosphaturic mesenchymal tumor is a challenging diagnosis to make—patients present with vari...

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Bibliographic Details
Published in:Skeletal radiology 2024-05, Vol.53 (5), p.995-1002
Main Authors: Gu, Joey, Ge, Connie, Joshi, Ganesh, Most, Mathew, Tai, Ryan
Format: Article
Language:English
Subjects:
Bone diseases
Bone marrow
Case Report
Case reports
Computed tomography
Diagnosis
Edema
Fractures
Functional magnetic resonance imaging
Humans
Imaging
Literature reviews
Medical imaging
Medicine
Medicine & Public Health
Mesenchymoma - complications
Metabolism
Neoplasms
Neoplasms, Connective Tissue - pathology
Nuclear Medicine
Oncology
Orthopedics
Osteomalacia
Osteoporosis
Pain
Paraneoplastic Syndromes - complications
Paraneoplastic Syndromes - diagnosis
Paraneoplastic Syndromes - surgery
Pathology
Patients
Phosphorus
Radiology
Scintigraphy
Soft Tissue Neoplasms - pathology
Soft tissues
Tumors
Vitamin deficiency
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Summary:Phosphaturic mesenchymal tumors are rare, usually benign neoplasms that occur in the soft tissue or bone and are the cause of nearly all cases of tumor-induced osteomalacia. Tumor-induced osteomalacia due to phosphaturic mesenchymal tumor is a challenging diagnosis to make—patients present with variable clinical and radiologic findings and the culprit neoplasm is often small and can occur anywhere head to toe. We present two cases of phosphaturic mesenchymal tumor in the scapular body and plantar foot. In both cases, the patient endured years of debilitating symptoms before a tissue diagnosis was eventually reached. Descriptions of clinical presentation, laboratory workup, surgical resection, and imaging characteristics, with a focus on CT, MRI, and functional imaging, are provided to assist with the diagnosis and management of this rare entity. A brief review of current literature and discussion of the differential diagnoses of phosphaturic mesenchymal tumor is also provided.
ISSN:0364-2348
1432-2161
DOI:10.1007/s00256-023-04462-w