Spinal phosphaturic mesenchymal tumors: Case report and literature review

Tumor-induced osteomalacia (TIO) is regarded as a rare paraneoplastic syndrome generally caused by phosphaturic mesenchymal tumors (PMTs). As far as we know, only 18 spinal PMTs have been described in the world's English literature. The purpose of this study is to increase familiarity with its clinical features, diagnosis, and treatment of spinal PMTs. A 34-year-old woman presented with bone pain for more than 3 years and was found to have decreased serum phosphorus, elevated serum alkaline phosphatase. A full body ⁶⁸Ga-DOTA-TATE PET/CT revealed increased uptake at the left posterior L5 neural arch. Then the tumor was totally resection and the histopathology revealed a PMT. Postoperatively, the patient's symptoms were relieved and experienced no recurrence during the 3-year follow-up. Generally, the preoperative diagnosis and location of spinal PMT still remains challenging. We also retrospectively analyzed 18 cases of patients with spinal PMTs published in English. Clinical symptoms, laboratory findings, treatment and outcome were retrospectively analyzed. Spinal PMTs are extraordinary and it is challengeable in locating tumors. Besides surgical resection, the treatment also included radiation, monoclonal antibodies or medical therapy. However, the optimal treatment remains controversial. Therefore, we should exert all our energies on the exploration of etiology and adjuvant therapy for this disease.