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Malignant phosphaturic mesenchymal tumor-ossifying fibroma-like subtype: a case report and literature review
Hongyu Qin1, Hao Zeng1, Hao Li1
1The First Affiliated Hospital of Guangxi Medical University, Shuangyong Rd, Qingxiu District, Nanning, GuangXi, China.
Background:
A phosphaturic mesenchymal tumor (PMT) is classified into four histological subtypes: mixed connective tissue, osteoblast-like, non-ossifying fibroma-like, and ossifying fibroma-like. The ossifying fibroma-like subtype being extremely rare. Most PMTs are benign, with a minimal number becoming malignant after recurrence. In this study, we report a case of recurrence and malignant transformation of PMT-ossifying fibroma-like subtype in the left hip bone.
Case Presentation:
Here, we report the clinical manifestations, histology, pathological features, and treatment of a 57-year-old Chinese woman with a recurrent and malignant ossifying fibroma-like subtype PMT of the left iliac bone. The tumor was first discovered 3 years ago when the patient underwent surgery to remove the tumor. Precisely 2 years and 6 months after the operation, the pain in the left hip reappeared. After 6 months, the patient went to our hospital for treatment. After the tumor resection, the postoperative symptoms improved significantly, and the serum alkaline phosphatase level returned to normal. Based on clinical manifestations, evaluation of serum biochemical indicators, X-ray examination, computerized tomography scan of the pelvis, and histopathological examination of the two operations, the patient was finally diagnosed with a recurring and malignant transformation of the left iliac bone phosphaturic mesenchymal tumor-ossifying fibroma-like subtype. No tumor recurrence was found during the follow-up 15 months after the operation.
Conclusions:
This case increases the awareness of a rare malignant subtype of PMT and provides a valuable reference for the diagnosis of this disease.
Insights
This case study details a rare instance of malignant transformation in an ossifying fibroma-like phosphaturic mesenchymal tumor (PMT) of the hip bone. The report highlights the importance of recognizing this rare PMT subtype for accurate diagnosis and treatment.
Area of Science:
- Oncology
- Pathology
- Orthopedics
Background:
- Phosphaturic mesenchymal tumors (PMTs) are rare neoplasms with four histological subtypes.
- The ossifying fibroma-like subtype is exceptionally uncommon.
- While typically benign, PMTs can rarely undergo malignant transformation after recurrence.
Observation:
- A 57-year-old woman presented with recurrent left iliac bone tumor.
- Initial diagnosis was an ossifying fibroma-like PMT, treated surgically.
- Recurrence 2.5 years later led to diagnosis of malignant transformation.
Findings:
- Histopathological examination confirmed recurrent and malignant ossifying fibroma-like PMT.
- Surgical resection led to significant symptom improvement and normalization of serum alkaline phosphatase.
- No recurrence observed during 15 months of follow-up.
Implications:
- This case underscores the potential for malignant transformation in rare PMT subtypes.
- It serves as a valuable reference for diagnosing and managing similar rare bone tumors.
- Increased awareness of this rare malignant PMT subtype is crucial for oncologists and orthopedic surgeons.
