Surgical treatment of tumor-induced osteomalacia: a retrospective review of 40 cases with extremity tumors

Abstract

BackgroundTumor-induced osteomalacia (TIO) is a rare syndrome typically caused by mesenchymal tumors. It has been shown that complete tumor resection may be curative. However, to our knowledge, there has been no report of a large cohort to exam different surgical approaches. This study was aimed to assess outcomes of different surgical options of patients with tumor-induced osteomalacia at a single institution.MethodsPatients with extremity tumors treated in our hospital from January, 2004 to July, 2012 were identified. The minimum follow-up period was 12 months. Patient’s demography, tumor location, preoperative preparation, type of surgeries were summarized, and clinical outcomes were recorded. Successful treatment was defined as significant symptom improvement, normal serum phosphorus and significant improvement or normalization of bone mineral density at the last follow-up. Differences between patients with soft tissue tumors and bone tumors were compared.ResultsThere were 40 (24 male and 16 female) patients identified, with an average age of 44 years. The tumors were isolated in either soft tissue (25 patients) or bone (12 patients) and combined soft tissue and bone invasion was observed in 3 patients. For the primary surgery, tumor resection and tumor curettage were performed. After initial surgical treatment, six patients then received a second surgery. Four patients were found to have malignant tumors base on histopathology. With a minimum follow-up period of 12 months, 80% of patients (32/40) were treated successfully, including 50% of patients (2/4) with malignant tumors. Compared to patients with bone tumor, surgical results were better in patient with soft tissue tumor.ConclusionsSurgical treatment was an effective way for TIO. Other than tumor curettage surgery, tumor resection is the preferred options for these tumors.

Nonremission and Recurrent Tumor-Induced Osteomalacia: A Retrospective Study

“…The overall recovery rate was 88.4% in our cohort. Previously reported recovery rates in other studies have varied from 72.7% to 100% . Small sample sizes, gaps in medical resources, focuses on different tumor locations, and different follow‐up periods of these studies all led to discrepancies.…”

“…Previously reported recovery rates in other studies have varied from 72.7% to 100%. (4,5,(9)(10)(11)(12) Small sample sizes, gaps in medical resources, focuses on different tumor locations, and different follow-up periods of these studies all led to discrepancies. The result of our cohort may provide convincing evidence for this predicament.…”

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].…”

Successful treatment of tumour-induced osteomalacia after resection of an oral peripheral ossifying fibroma

“…Definitive treatment for TIO is complete excision of the functioning tumour 9. The metabolic parameters are expected to rapidly return to normal as FGF23 has a short half-life of 45 min 10.…”