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Phosphaturic mesenchymal tumor: Case report.

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Phosphaturic mesenchymal tumors (PMT) are rare causes of osteomalacia. Early diagnosis of these tumors can be improved by considering them in the differential diagnosis and monitoring serum phosphate levels.

Keywords:
Phosphaturic mesenchymal tumor

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Area of Science:

  • Oncology
  • Endocrinology
  • Pathology

Background:

  • Phosphaturic mesenchymal tumors (PMT) are exceedingly rare neoplasms.
  • They present as a paraneoplastic syndrome causing tumor-induced osteomalacia.
  • Diagnosis is frequently delayed due to vague symptoms and rarity.

Observation:

  • A case report details a 37-year-old African American male with a 5-year history of progressive quadriparesis.
  • Initial imaging identified a pelvic soft tissue mass, initially deemed insignificant.
  • Severe hypophosphatemia (serum phosphate < 1 mg/dL) prompted re-evaluation.

Findings:

  • Advanced imaging, including 99mTc bone scintigraphy and MRI, characterized the tumor.
  • Serum fibroblast growth factor 23 (FGF23) levels and histopathology confirmed the PMT diagnosis.
  • The tumor was surgically removed, leading to resolution of symptoms.

Implications:

  • Including PMT in the differential diagnosis for osteomalacia can reduce diagnostic delays.
  • Monitoring serum phosphate levels is crucial for identifying potential PMT cases.
  • Prompt diagnosis and treatment of PMT can prevent long-term morbidity associated with osteomalacia.