CT and MR imaging features in phosphaturic mesenchymal tumor-mixed connective tissue: A case report

Shi, Zhang; Deng, Yiqiong; Li, Xiumei; Li, Yueming; Cao, Dairong; Coossa, Vikash Sahadeo

doi:10.3892/ol.2018.7945

Cited by 12 publications

(20 citation statements)

References 69 publications

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“…If suspected somatostatin-expressing lesions are found, they can be accurately localised by CT or MRI. 13 In recent years, FGF-23 levels have been detected to determine whether there is TIO disease. Abnormal density of left maxillary sinus and abnormal changes of adjacent bone were found by CT in this patient.…”

Section: Discussionmentioning

confidence: 99%

Left maxillary sinus tumour‐induced hypophosphataemic osteomalacia and combined with thyroid papillary carcinoma: a case report and literature review

Dong

Liu

et al. 2020

Internal Medicine Journal

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Tumour-induced osteomalacia (TIO) is a rare disease characterised by hypophosphataemia and clinical symptoms of osteomalacia. Herein we report the case of a 29-year-old man who was admitted to hospital with progressive bone pain and was diagnosed with TIO caused by maxillary sinus tumours. In the preoperative evaluation, it was found that the patient had thyroid malignant tumours at the same time. Two operations were performed separately on the left maxillary sinus tumour and thyroid tumour after complete examination. After tumour resections, the symptoms of bone pain were relieved and the level of blood phosphorus was restored, long-term replacement therapy was needed for thyroid. When a patient is diagnosed with TIO, it is necessary to screen for the presence of other malignant tumours and explore the treatment options in order to benefit patients preferably. AbstractMechanical ventilation as a resource is limited and may lead to poor outcomes in at-risk populations. Critical care supports may not be preferred by those at risk of deterioration in the COVID-19 setting. Patient-centred communication and shared decision-making should continue to remain central to clinical practice.

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Section: Discussionmentioning

confidence: 99%

Left maxillary sinus tumour‐induced hypophosphataemic osteomalacia and combined with thyroid papillary carcinoma: a case report and literature review

Dong

Liu

et al. 2020

Internal Medicine Journal

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“…The focal problem with most PMTs is that they not only produce generalized nonspecific symptoms in characteristically middle-aged patients, but they are also usually quite small and challenging to locate [6]. These tumors have been found to originate from bone and soft tissue with 95% being identified in the extremities and appendicular skeleton [4], [7]. The importance of localizing these tumors cannot be understated as the majority of these patients suffer from debilitating pain and fatigue.…”

Section: Discussionmentioning

confidence: 99%

“…A larger sized tumor appears more heterogeneous on T2 and T1 weighted imaging with a similar heterogeneous pattern on post-contrast T1 weighted imaging. These heterogenous discrepancies are associated with areas of vascular flow voids within larger PMTs [4].…”

Section: Discussionmentioning

confidence: 99%

Phosphaturic mesenchymal tumor: Case report

Richardson

2019

Radiology Case Reports

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Phosphaturic mesenchymal tumors (PMT) are an extremely rare pathologic phenomenon that presents as paraneoplastic tumor-induced osteomalacia. Their diagnosis is often significantly delayed due to their rare occurrence in addition to the generalized and vague symptoms of their presentation including progressive bone pain, myopathies, arthralgias, fractures, and generalized weakness. This case report identifies a very characteristic presentation of a 37-year old African American male suffering from a PMT; with symptom onset presenting over 5-years prior to presentation with a consistent complaint of progressive and debilitating quadriparesis. The tumor was first identified by pelvic computerized tomography, although it was initially thought to be a noncontributory benign soft tissue mass. It was only after being hospitalized due to a severe and unresponsive hypophosphatemic state (less than 1 mg/dl) that the collective differential switched to one of a PMT with follow up nuclear 99mTc bone scintigraphy and magnetic resonance imaging being used to aid in the overall assessment of changes, extent, and general metabolic properties of the tumor. The confirmatory diagnosis of a PMT was later established through both serum fibroblast growth factor 23 testing and histopathologic review of the surgically removed specimen. By including this rare but curative disease into the differential of osteomalacia and thereby further examining patient serum phosphate levels, the previous 5-7 year delay in diagnosis will be dramatically reduced.

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“…PMT is a rare soft tissue tumour with the potential to cause profound clinical effects. Few cases have been reported in the literature . It can be challenging both to diagnose and treat.…”

mentioning

confidence: 99%

“…Despite its rarity, PMT is the most common cause of tumour‐induced osteomalacia . It presents most frequently in middle‐aged patients . The tumour is commonly present in the soft tissues or bones of the extremities .…”

mentioning

confidence: 99%

Phosphaturic mesenchymal tumour: an interesting diagnostic and surgical case of tumour‐induced osteomalacia

Clarnette

Jagiello

Farshid

et al. 2020

ANZ Journal of Surgery

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Nonetheless, no features of intrinsic appendicitis or malignancy were seen. The patient had a smooth recovery and was discharged on postoperative day 5, with further gynaecology follow-up. Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Up to 6-10% of the general female population may be affected by this condition. 1 Intestinal involvement may occur in 3-34% of females with endometriosis; however, the sigmoid colon and rectum are most commonly affected. 2 Appendiceal endometriosis is rare with a reported incidence of 2.8%. 3 Symptomatic endometriosis of the appendix is highly variable in presentation and may mimic acute appendicitis or other general surgical pathology. Presentations including caecal intussusception, gastrointestinal perforation and per rectal bleeding have all been reported. 4 Differentiating these conditions can be highly challenging. Whilst endometriosis is familiar to gynaecologists, this case explores the atypical presentation and diagnostic challenges appendiceal endometriosis may pose to general surgeons, particularly the mimicry of familiar general surgical pathology. In our case, the patient's presenting symptoms and history were concerning for subacute appendicitis; however intraoperatively, malignancy was a differential diagnosis. Post-operatively, the patient's pain subsided, suggesting that the appendiceal endometrial deposits were the cause for symptoms. Nevertheless, in patients found to have appendiceal endometriosis, ongoing pain despite appendicectomy warrants investigation for other abdominopelvic endometrial deposits or nongynaecological diagnoses.

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CT and MR imaging features in phosphaturic mesenchymal tumor-mixed connective tissue: A case report

Cited by 12 publications

References 69 publications

Left maxillary sinus tumour‐induced hypophosphataemic osteomalacia and combined with thyroid papillary carcinoma: a case report and literature review

Left maxillary sinus tumour‐induced hypophosphataemic osteomalacia and combined with thyroid papillary carcinoma: a case report and literature review

Phosphaturic mesenchymal tumor: Case report

Phosphaturic mesenchymal tumour: an interesting diagnostic and surgical case of tumour‐induced osteomalacia

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