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Unusual Presentation and Surgical Treatment of a Phosphaturic Mesenchymal Tumor in a Knee

A 30-year-old woman presented to our hospital with an 11-year history of gradually enlarging masses around the left knee and 2-year history of progressively worsening bone pain. Tumor-induced osteomalacia (TIO), a rare paraneoplastic syndrome caused by phosphaturic mesenchymal tumors (PMTs) was susp...

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Autores principales: Sun, Juan, Zhou, Xi, Xia, Weibo, Wu, Huanwen, Liu, Shuzhong, Wang, Huizhen, Liu, Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9174667/
https://www.ncbi.nlm.nih.gov/pubmed/35693311
http://dx.doi.org/10.3389/fsurg.2022.746623
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author Sun, Juan
Zhou, Xi
Xia, Weibo
Wu, Huanwen
Liu, Shuzhong
Wang, Huizhen
Liu, Yong
author_facet Sun, Juan
Zhou, Xi
Xia, Weibo
Wu, Huanwen
Liu, Shuzhong
Wang, Huizhen
Liu, Yong
author_sort Sun, Juan
collection PubMed
description A 30-year-old woman presented to our hospital with an 11-year history of gradually enlarging masses around the left knee and 2-year history of progressively worsening bone pain. Tumor-induced osteomalacia (TIO), a rare paraneoplastic syndrome caused by phosphaturic mesenchymal tumors (PMTs) was suspected, but the postoperative pathology of her two operations was both reported as tenosynovial giant cell tumor (TGCT), making its diagnosis confusing. The possibility of hypophosphatemia, insufficient blood supply, innervation of the left lower limbs, as well as the unclear pathology, make it unreasonable to perform tumor-type knee prosthesis replacement directly. Finally, we placed static polymethylmethacrylate (PMMA) spacer at first, then when the concentration of blood phosphorus level rose to the normal range, the pathology was confirmed to be TIO, the blood supply and innervation was satisfying, tumor-type knee prosthesis replacement was performed. She was discharged post operative day 15 after the prothesis implantation without incident. One and a half years after her surgery, the concentration of blood phosphorus was still in the normal range, the symptom of systemic bone pain had improved significantly, the prosthesis was still in a good position and no recurrence was caught.
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spelling pubmed-91746672022-06-09 Unusual Presentation and Surgical Treatment of a Phosphaturic Mesenchymal Tumor in a Knee Sun, Juan Zhou, Xi Xia, Weibo Wu, Huanwen Liu, Shuzhong Wang, Huizhen Liu, Yong Front Surg Surgery A 30-year-old woman presented to our hospital with an 11-year history of gradually enlarging masses around the left knee and 2-year history of progressively worsening bone pain. Tumor-induced osteomalacia (TIO), a rare paraneoplastic syndrome caused by phosphaturic mesenchymal tumors (PMTs) was suspected, but the postoperative pathology of her two operations was both reported as tenosynovial giant cell tumor (TGCT), making its diagnosis confusing. The possibility of hypophosphatemia, insufficient blood supply, innervation of the left lower limbs, as well as the unclear pathology, make it unreasonable to perform tumor-type knee prosthesis replacement directly. Finally, we placed static polymethylmethacrylate (PMMA) spacer at first, then when the concentration of blood phosphorus level rose to the normal range, the pathology was confirmed to be TIO, the blood supply and innervation was satisfying, tumor-type knee prosthesis replacement was performed. She was discharged post operative day 15 after the prothesis implantation without incident. One and a half years after her surgery, the concentration of blood phosphorus was still in the normal range, the symptom of systemic bone pain had improved significantly, the prosthesis was still in a good position and no recurrence was caught. Frontiers Media S.A. 2022-05-25 /pmc/articles/PMC9174667/ /pubmed/35693311 http://dx.doi.org/10.3389/fsurg.2022.746623 Text en Copyright © 2022 Sun, Zhou, Xia, Wu, Liu, Wang and Liu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Sun, Juan
Zhou, Xi
Xia, Weibo
Wu, Huanwen
Liu, Shuzhong
Wang, Huizhen
Liu, Yong
Unusual Presentation and Surgical Treatment of a Phosphaturic Mesenchymal Tumor in a Knee
title Unusual Presentation and Surgical Treatment of a Phosphaturic Mesenchymal Tumor in a Knee
title_full Unusual Presentation and Surgical Treatment of a Phosphaturic Mesenchymal Tumor in a Knee
title_fullStr Unusual Presentation and Surgical Treatment of a Phosphaturic Mesenchymal Tumor in a Knee
title_full_unstemmed Unusual Presentation and Surgical Treatment of a Phosphaturic Mesenchymal Tumor in a Knee
title_short Unusual Presentation and Surgical Treatment of a Phosphaturic Mesenchymal Tumor in a Knee
title_sort unusual presentation and surgical treatment of a phosphaturic mesenchymal tumor in a knee
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9174667/
https://www.ncbi.nlm.nih.gov/pubmed/35693311
http://dx.doi.org/10.3389/fsurg.2022.746623
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