Preoperative evaluation and orthopedic surgical strategies for tumor-induced osteomalacia

Liu, Shuzhong; Zhou, Xi; Liu, Yong; Zhang, Jianguo; Xia, Weibo

doi:10.1016/j.jbo.2024.100600

Cited by 1 publication

(3 citation statements)

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“…In April 2024, our team authored the first review of the preoperative evaluation and orthopedic surgical strategies used for patients with TIO, published in the Journal of Bone Oncology . 10 In this study, we summarized and analyzed the clinical features and orthopedic surgical treatment effects of patients with TIO in our institution, whose culprit tumors are located in the hip bones.…”

Section: Discussionmentioning

confidence: 99%

“…In cases where disease recurrence or unresolved symptoms are observed during the follow‐up process, further localization or other treatment options should be performed according to the diagnosis and treatment flowchart of the TIO orthopedic surgical treatment strategy. 10 …”

Section: Methodsmentioning

confidence: 99%

“…The orthopedic surgical strategy for patients with TIO is a recent development, and the diagnosis, treatment, and prognosis of patients with causative tumors in different locations may vary. 10 This is especially true when tumors are situated in surgically difficult regions, such as the hip bones, and presents challenges for orthopedic surgeons. Therefore, the surgical treatment of such tumors is an important issue that requires further in‐depth research.…”

Section: Introductionmentioning

confidence: 99%

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Orthopedic Surgical Treatment of Patients with Tumor‐induced Osteomalacia Located in the Hip Bones: A Retrospective Analysis of 10 Years in a Single Center

Liu,

Zhou,

Liang

et al. 2024

Orthopaedic Surgery

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ObjectiveThe orthopedic surgical treatment strategies for patients with tumor‐induced osteomalacia (TIO) require improvement, especially for patients where the causative tumors are located in surgically challenging areas, requiring a greater degree of in‐depth investigation. This work aims to summarize and investigate clinical features and orthopedic surgical treatment effects of patients with tumor‐induced osteomalacia (TIO), whose causative tumors are located in the hip bones.MethodsA retrospective analysis was conducted on the clinical data of all patients diagnosed with culprit tumors located in the hip bones who underwent surgical treatment at the orthopedic bone and soft tissue tumor sub‐professional group of Peking Union Medical College Hospital from January 2013 to January 2023. This retrospective study summarized the clinical data, preoperative laboratory test results, imaging findings, surgery‐related data, perioperative changes in blood phosphorus levels, and postoperative follow‐up data of all patients who met the inclusion criteria. Normally distributed data are presented as mean and standard deviation, while non‐normally distributed data are shown as the means and 25th and 75th interquartile ranges.ResultsThe clinical diagnostic criteria for TIO were met by all 16 patients, as confirmed by pathology after surgery. Among the 16 patients, we obtained varying degrees of bone pain and limited mobility (16/16), often accompanied by difficulties in sitting up, walking, and fatigue. An estimated 62.5% (10/16) of patients had significantly shorter heights during the disease stages. All 16 patients underwent surgical treatment for tumors in the hip bones, totaling 21 surgeries. In the pathogenic tumor, there were 16 cases of skeletal involvement and none of pure soft tissue involvement. Out of the 16 patients, 13 cases had a gradual increase in blood phosphorus levels following the latest orthopedic surgery, which was followed up for 12 months to 10 years. Due to unresolved conditions after the original surgery, four patients received reoperation intervention. Two cases of refractory TIO did not improve in their disease course.ConclusionIn summary, the location of the causative tumor in the hip bone is hidden and diverse, and there is no defined orthopedic surgical intervention method for this case in clinical practice. For patients with TIO where the tumors are located in the hip bones, surgical treatment is difficult and the risk of postoperative recurrence is high. Careful identification of the tumor edge using precise preoperative positioning and qualitative diagnosis is crucial to ensure adequate boundaries for surgical resection to reduce the likelihood of disease recurrence and improve prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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