Phosphaturic mesenchymal tumors among elderly patients: a case report and review of literature
Phosphaturic mesenchymal tumor (PMT) represents a rare cause of osteomalacia. The clinical signs and symptoms are vague and these lead to diagnosis delay. In the presence of hypophosphatemia and relatively high urine phosphate excretion, this entity should be taken into consideration in the defere...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2019-05-01
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| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://edm.bioscientifica.com/view/journals/edm/2019/1/EDM18-0139.xml |
| Summary: | Phosphaturic mesenchymal tumor (PMT) represents a rare cause of osteomalacia. The clinical signs and symptoms are
vague and these lead to diagnosis delay. In the presence of hypophosphatemia and relatively high urine phosphate
excretion, this entity should be taken into consideration in the deferential diagnosis of osteomalacia. In the present article,
we report 81-year-old man presented to our clinic for evaluation due to osteopenia. His laboratory results disclosed hypophosphatemia, relatively increased urine phosphate excretion and increased level of intact fibroblast growth factor
23 (FGF23). A 68Gallium DOTATATE PET/CT revealed pathological uptake in the upper aspect of the left shoulder adjacent to the coracoid process. For suspected PMT a wide resection of the tumor was performed and pathological findings
were consistent for PMT. Laboratory tests were normalized postoperatively. Reviewing the literature, we had identified
33 reported cases of PMTs among elderly patients age ≥70 years. Unlike previously reported data, where tumors predominantly localized in the lower extremities and pelvis, our search disclosed a high rate of tumor localization (10 cases– 33.3%) in the head with equal number of tumors (14 cases – 42.4%) localized in the head and upper extremity as well as in pelvis and lower extremity. The present case describes unique tumor localization in an elderly patient and our literature search demonstrated for the first time a high rate of tumor localization in the head among this group of patients. |
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| ISSN: | 2052-0573 2052-0573 |