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Phosphaturic Mesenchymal Tumors: Rethinking the Clinical Diagnosis and Surgical Treatment

Background: The diagnosis of phosphaturic mesenchymal tumors (PMT) is easily delayed clinically, and their surgical treatment is unstandardized. This study aimed to evaluate our experience in the diagnosis and treatment of PMT and provide a research basis for the accurate and standardized treatment...

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Autores principales: Liu, Yupeng, He, Hongbo, Zhang, Can, Zeng, Hao, Tong, Xiaopeng, Liu, Qing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821698/
https://www.ncbi.nlm.nih.gov/pubmed/36615052
http://dx.doi.org/10.3390/jcm12010252
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author Liu, Yupeng
He, Hongbo
Zhang, Can
Zeng, Hao
Tong, Xiaopeng
Liu, Qing
author_facet Liu, Yupeng
He, Hongbo
Zhang, Can
Zeng, Hao
Tong, Xiaopeng
Liu, Qing
author_sort Liu, Yupeng
collection PubMed
description Background: The diagnosis of phosphaturic mesenchymal tumors (PMT) is easily delayed clinically, and their surgical treatment is unstandardized. This study aimed to evaluate our experience in the diagnosis and treatment of PMT and provide a research basis for the accurate and standardized treatment of PMT. Materials and Methods: Twelve patients diagnosed with PMT in our department and who underwent surgical treatment were included in this study. Preoperative demographic and clinical information were recorded. CT, MRI, and technetium-99m (Tc99m)-octreotide PET/CT imaging techniques were used to evaluate the general conditions and lesion boundaries of the tumors. Surgical treatment was performed using radical resection and microwave ablation-assisted extended curettage according to the lesion location and size. Patients were strictly followed up with and evaluated for oncological prognosis, radiological results, bone healing, serum ion levels, limb function, and pain level; the occurrence of complications was also recorded. Results: Three patients underwent radical resection, and nine underwent microwave ablation-assisted extended curettage. The average duration of symptoms in this group was 1.5 years (9–35 months) before diagnosis. Serum phosphate and AKP levels returned to normal one and two weeks postoperatively, respectively. There was no apparent specificity in the pathological findings; however, the immunohistochemistry of FGF-23 was positive, and the original fracture sites were effectively healed during the follow-up. The limb function and pain scores were significantly improved. The MSTS score increased from 15.3 to 29.0, and the VAS score decreased from 5.3 to 0.4. All patients recovered, and 90% resumed their original jobs. Conclusions: Accurate diagnosis and standardized surgical treatment are crucial to achieving a clinical cure for PMT. Combining clinical manifestations, biochemical examinations, imaging characteristics, and pathological findings is an effective way to diagnose PMT accurately. Radical resection and microwave ablation-assisted extended curettage are reliable surgical treatment methods for PMT.
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spelling pubmed-98216982023-01-07 Phosphaturic Mesenchymal Tumors: Rethinking the Clinical Diagnosis and Surgical Treatment Liu, Yupeng He, Hongbo Zhang, Can Zeng, Hao Tong, Xiaopeng Liu, Qing J Clin Med Article Background: The diagnosis of phosphaturic mesenchymal tumors (PMT) is easily delayed clinically, and their surgical treatment is unstandardized. This study aimed to evaluate our experience in the diagnosis and treatment of PMT and provide a research basis for the accurate and standardized treatment of PMT. Materials and Methods: Twelve patients diagnosed with PMT in our department and who underwent surgical treatment were included in this study. Preoperative demographic and clinical information were recorded. CT, MRI, and technetium-99m (Tc99m)-octreotide PET/CT imaging techniques were used to evaluate the general conditions and lesion boundaries of the tumors. Surgical treatment was performed using radical resection and microwave ablation-assisted extended curettage according to the lesion location and size. Patients were strictly followed up with and evaluated for oncological prognosis, radiological results, bone healing, serum ion levels, limb function, and pain level; the occurrence of complications was also recorded. Results: Three patients underwent radical resection, and nine underwent microwave ablation-assisted extended curettage. The average duration of symptoms in this group was 1.5 years (9–35 months) before diagnosis. Serum phosphate and AKP levels returned to normal one and two weeks postoperatively, respectively. There was no apparent specificity in the pathological findings; however, the immunohistochemistry of FGF-23 was positive, and the original fracture sites were effectively healed during the follow-up. The limb function and pain scores were significantly improved. The MSTS score increased from 15.3 to 29.0, and the VAS score decreased from 5.3 to 0.4. All patients recovered, and 90% resumed their original jobs. Conclusions: Accurate diagnosis and standardized surgical treatment are crucial to achieving a clinical cure for PMT. Combining clinical manifestations, biochemical examinations, imaging characteristics, and pathological findings is an effective way to diagnose PMT accurately. Radical resection and microwave ablation-assisted extended curettage are reliable surgical treatment methods for PMT. MDPI 2022-12-29 /pmc/articles/PMC9821698/ /pubmed/36615052 http://dx.doi.org/10.3390/jcm12010252 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Liu, Yupeng
He, Hongbo
Zhang, Can
Zeng, Hao
Tong, Xiaopeng
Liu, Qing
Phosphaturic Mesenchymal Tumors: Rethinking the Clinical Diagnosis and Surgical Treatment
title Phosphaturic Mesenchymal Tumors: Rethinking the Clinical Diagnosis and Surgical Treatment
title_full Phosphaturic Mesenchymal Tumors: Rethinking the Clinical Diagnosis and Surgical Treatment
title_fullStr Phosphaturic Mesenchymal Tumors: Rethinking the Clinical Diagnosis and Surgical Treatment
title_full_unstemmed Phosphaturic Mesenchymal Tumors: Rethinking the Clinical Diagnosis and Surgical Treatment
title_short Phosphaturic Mesenchymal Tumors: Rethinking the Clinical Diagnosis and Surgical Treatment
title_sort phosphaturic mesenchymal tumors: rethinking the clinical diagnosis and surgical treatment
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821698/
https://www.ncbi.nlm.nih.gov/pubmed/36615052
http://dx.doi.org/10.3390/jcm12010252
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