Oncogenic Osteomalacia due to Recurrent Phosphaturic Mesench
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Phosphaturic mesenchymal tumor is a neoplasm that releases phosphaturic substances known as the fibroblast growth factor-23 (FGF-23). It results in increased renal excretion of phosphate, decreased blood phosphate levels, tumor-induced osteomalacia (oncogenic osteomalacia), and secondary hyperparathyroidism.

A 61-year-old lady presented with complaints of generalized tiredness and body ache of 1-year duration. She had a previous history of tumor-induced osteomalacia due to a mesenchymal tumor in the right inguinal region and tumor excision in 2010.

Biopsy at that time was suggestive of a mesenchymal tumor. On further evaluation, she was found to have hypophosphatemia, phosphaturia, and secondary hyperparathyroidism. Contrast-enhanced MRI showed a doubtful lesion in the right obturator canal, which was further confirmed by 68Ga-DOTATOC whole-body PET/CT.

She underwent complete excision of the lesion followed by Prolene mesh repair of the defect. Phosphaturia and hypophosphatemia improved after excision. She was symptom-free after 1 month. She developed mild seroma over the surgical site after 1 month, which settled on radiological drainage.

In particular, phosphaturic mesenchymal tumor is a rare cause of oncogenic osteomalacia and secondary hypoparathyroidism. 68Ga-DOTATOC whole-body PET/CT is helpful in localizing the lesion. Complete excision of the tumor ensures complete recovery of the patient from the disease.

Indian Journal of Surgery
Source: https://doi.org/10.1007/s12262-021-02895-y
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