Surgical Treatments of Tumor-Induced Osteomalacia Lesions in Long Bones

Abstract

Most lesions in long bones are located in the epiphysis, so curettage is first suggested to maintain joint function. If curettage is incomplete or there is a recurrence, secondary segmental resection should be considered curative. Changes of serum FGF-23 and phosphorus levels before and after the operation may be of prognostic help.

Three-dimensional fluoroscopic navigation-assisted surgery for tumors in patients with tumor-induced osteomalacia in the bones

“…Surgical treatment is recommended for patients with TIO in the bones, although there are several medical approaches [5][6][7]. If the tumor is not completely excised, patients with TIO cannot be cured [8,9]. Onethird of these tumors have been reported to occur in the bones, and the options for surgical treatment of tumors in the bones are tumor curettage and tumor segment resection [7].…”

“…Onethird of these tumors have been reported to occur in the bones, and the options for surgical treatment of tumors in the bones are tumor curettage and tumor segment resection [7]. Previous studies have recommended segmental resection because tumor curettage was found to be associated with a high local recurrence rate [8,9]. Navigation-assisted surgery provides radiological information to guide the surgeon during surgery, and it has been reported to help safely resect malignant bone tumors, resulting in improved oncological and functional outcomes [10,11].…”

Total hip/knee arthroplasty in the treatment of tumor-induced osteomalacia patients: More than 1 year follow-up

“…Due to its rarity, few studies have focused on the surgical treatment strategy to achieve a better prognosis [4]. A tumor located on the long bone metaphysis, especially in unique areas such as the femoral head or tibial plateau, lack surgical guidelines.…”

“…Wang et al [4] indicated that although segmental resection could ensure complete resection of the tumor, it would destroy the anatomic structure of the joint. To solve this problem, an artificial joint prosthesis or allogeneic bone segment should be followed to reconstruct the structure.…”

“…X-ray, CT, and magnetic resonance imaging (MRI) were used to confirm the anatomic location. Above is the stepwise diagnostic approach that we previously reported [4]. Patients with a tumor located on the metaphysis and poor joint function were recommended to undergo arthroplasty.…”