Whole-body MR Imaging in Detecting Phosphaturic Mesenchymal Tumor (PMT) in Tumor-induced Hypophosphatemic Osteomalacia

Nakanishi, Katsuyuki; Sakai, Mio; Tanaka, Hisashi; Hideki, Tsuboi; Hashimoto, Jun; Hashimoto, Nobuyuki; Tomiyama, Noriyuki

doi:10.2463/mrms.2011-0006

Cited by 19 publications

(11 citation statements)

References 16 publications

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“…Successful tumor localization has also been reported in some patients with PET/CT [ 28 , 29 ]. However, considering the small and occult nature of TIO, it might not be seen as increased uptake of PET/CT utilization [ 30 ]. WB-MRI has been well established to have no radiological exposure and offers excellent contrast resolution of bone, soft tissue, and subcutaneous regions.…”

Section: Discussionmentioning

confidence: 99%

En bloc resection for treatment of tumor-induced osteomalacia: a case presentation and a systematic review

Meng

Wang

et al. 2015

World J Surg Onc

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BackgroundTumor-induced osteomalacia (TIO) is a rare disorder, which is commonly found in craniofacial locations and in the extremities. To the best of our knowledge, only 16 cases have been described in the spine, and this is the first report to describe a case of patient with TIO in the thoracic spine combined with a mesenchymal hamartoma which had confused the therapeutic strategies to date.Case descriptionWe report the case of a 60-year-old patient with hypophosphatemia and presented with limb weakness. Treating with phosphate did not correct the hypophosphatemia and an 111In pentetreotide scintigraphy (octreotide scan) revealed an increased uptake at the right forearm. The tumor was resected totally, and the histopathology revealed a mesenchymal hamartoma, but we noticed that hypophosphatemia was not corrected after the tumor resection. Then a whole-body magnetic resonance imaging (WB-MRI) was performed and the results revealed tumorous tissues at the right T1 vertebral pedicle. The tumor was removed with an en bloc method, and the pathology showed phosphaturic mesenchymal tumor. Follow-up at 1 year after surgery revealed no recurrence, and the serum phosphorus level of the patient was normal.ConclusionsTumor-induced osteomalacia is exceedingly rare with only 16 cases in spine published in the literature. It is difficult to find and leads to years of suffering debilitating complications. In this regard, the WB-MRI is a better method to locate the real tumor. Treating with phosphate can only relieve symptoms, and a complete surgical removal remains the gold standard treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-015-0589-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

En bloc resection for treatment of tumor-induced osteomalacia: a case presentation and a systematic review

Meng

Wang

et al. 2015

World J Surg Onc

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“…Previous reports have shown that the differences between benign and malignant PMT are found in the infiltrative pattern of the primary tumour and the tumour size. 4 Nakanishi et al 9 reported that whole-body MRI using a single-shot short T 1 recovery-echo planar imaging sequence could show PMT as high intensity. These results imply that CT scan and MRI might be useful for assessing the localization of PMT.…”

Section: Discussionmentioning

confidence: 99%

Primary phosphaturic mesenchymal tumour of the lumbar spine: utility of ⁶⁸Ga-DOTATOC PET/CT findings

et al. 2016

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Primary phosphaturic mesenchymal tumours (PMTs) frequently occur in the soft tissue or bone, but rarely in the spine. The majority of patients experience long-term ostalgia and recurrent fractures. Detection of PMT can be challenging, but the clinical symptoms dramatically improve after removal of the tumour.Wepresent a case of primary PMT in the lumbar spine. CT scan showed a low-density tumour with a well-defined sclerotic margin in the L5 vertebra. MRI revealed a hypointense tumour on T2 weighted imaging and heterogeneous enhancement. 68Ga-labelled 1,4,7,10-tetraazacyclododecane-N,N′,N″, N‴-tetraacetic acid-D-Phe1-Tyr3-octreotide (68Ga-DOTATOC) positron emission tomography/CT scan demonstrated intense focal uptake within the tumour. Histologically, proliferation of oval to short spindle-shaped cells with fibrocollagenous stroma, abundant various-sized vessels, microcysts and thickened anastomosed bone trabeculae were seen. Mitotic figures were rarely seen. Immunohistochemically, the tumour cells were focally positive for fibroblast growth factor 23. The imaging findings in the current case are in accordance with the histological features. Among them, 68Ga-DOTATOC positron emission tomography/CT scan for somatostatin receptor imaging provides valuable information for determining PMT localization and characterization.

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“…First, drug: included aminoglycosides, valproate, methyl-3-chromone, paraquat [8],L-lysine [9], tetracycline, ifosfamide and adefovir. Second, tumor such as multiple myeloma and amyloidosis and so on [10]. Third, heavy metal poisoning, such as chromium and lead.…”

Section: Discussionmentioning

confidence: 99%

Misdiagnosis of Bone Metastasis Cancer After Using Adefovir Dipivoxi in a Hepatitis B Patient with Fanconi Syndrome

Shen

Sun

et al. 2015

Indian J Hematol Blood Transfus

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Adefovir dipivoxil is commonly used for treatment of chronic hepatitis B patients. We present a case of acquired Fanconi syndrome and hypophosphatemic osteomalacia in a patient with chronic hepatitis B who had been treated with ADV for 8 years. A 41-year-old man complained of severe bilateral hypochondrium pain and lower limb weakness, and he had the diagnosis of bone metastasis cancer or multiple myeloma. Laboratory results and radiologic findings suggested Fanconi syndrome with osteomalacia after hospitalized. For it is difficult to accurately diagnose in clinic and prone to misdiagnose, more attention should be paid to the kidney damage in the patients treated with long-term ADV.

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Whole-body MR Imaging in Detecting Phosphaturic Mesenchymal Tumor (PMT) in Tumor-induced Hypophosphatemic Osteomalacia

Cited by 19 publications

References 16 publications

En bloc resection for treatment of tumor-induced osteomalacia: a case presentation and a systematic review

En bloc resection for treatment of tumor-induced osteomalacia: a case presentation and a systematic review

Primary phosphaturic mesenchymal tumour of the lumbar spine: utility of ⁶⁸Ga-DOTATOC PET/CT findings

Misdiagnosis of Bone Metastasis Cancer After Using Adefovir Dipivoxi in a Hepatitis B Patient with Fanconi Syndrome

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Whole-body MR Imaging in Detecting Phosphaturic Mesenchymal Tumor (PMT) in Tumor-induced Hypophosphatemic Osteomalacia

Cited by 19 publications

References 16 publications

En bloc resection for treatment of tumor-induced osteomalacia: a case presentation and a systematic review

En bloc resection for treatment of tumor-induced osteomalacia: a case presentation and a systematic review

Primary phosphaturic mesenchymal tumour of the lumbar spine: utility of 68Ga-DOTATOC PET/CT findings

Misdiagnosis of Bone Metastasis Cancer After Using Adefovir Dipivoxi in a Hepatitis B Patient with Fanconi Syndrome

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Primary phosphaturic mesenchymal tumour of the lumbar spine: utility of ⁶⁸Ga-DOTATOC PET/CT findings