Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Jul 14;14(7):e26847.
doi: 10.7759/cureus.26847. eCollection 2022 Jul.

Phosphaturic Mesenchymal Tumor: An Unusual Cause of Stress Fractures Presenting to Sports Medicine

Rafat H Solaiman  1 , Christian M Ogilvie  1
Affiliations
Case Reports

Phosphaturic Mesenchymal Tumor: An Unusual Cause of Stress Fractures Presenting to Sports Medicine

Rafat H Solaiman et al. Cureus. .

Abstract

Phosphaturic mesenchymal tumors (PMT) are a rare neoplasm oftentimes associated with tumor-induced osteomalacia (TIO). The non-specific presentation and symptoms of these pathologies make them difficult to diagnose. We report a case of a 52-year-old patient with an intermetatarsal phosphaturic mesenchymal tumor who presented to the orthopedic sports medicine clinic with metabolic deficiencies and bilateral subtrochanteric cortical stress fractures indicative of osteomalacia. The tumor was entirely resected within nine months of symptom onset and has shown no recurrence at the one-year follow-up. This case report characterizes an unusual cause of stress fractures presenting to orthopedic sports medicine clinics and the variability in the presentation of phosphaturic mesenchymal tumors.

Keywords: intermetatarsal; oncology; orthopedic surgery; phosphaturic mesenchymal tumor; sports medicine; stress fractures; tumor-induced osteomalacia.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Radiograph of the pelvis and hip showing proximal femoral shaft lucencies indicative of stress fractures
Figure 2
Figure 2. Bone density test of the hips indicating osteopenia in the right and left hip with respective T-scores of -2.0 and -2.1
Figure 3
Figure 3. Magnetic resonance imaging displaying a soft-tissue mass with low signal intensity between the second and third metatarsal in a T-1 weighted sequence
Figure 4
Figure 4. Magnetic resonance imaging displaying a soft-tissue mass with high signal intensity between the second and third metatarsal in a short tau inversion recovery (STIR) imaging sequence
Figure 5
Figure 5. Histopathology from the tumor biopsy showing hypocellularity with myxoid matrix, grungy calcification, and bland nuclei
See this image and copyright information in PMC

References

    1. The diagnostic dilemma of tumor induced osteomalacia: a retrospective analysis of 144 cases. Feng J, Jiang Y, Wang O, et al. Endocr J. 2017;64:675–683. - PubMed
    1. FGF-23 is a potent regulator of vitamin D metabolism and phosphate homeostasis. Shimada T, Hasegawa H, Yamazaki Y, et al. J Bone Miner Res. 2004;19:429–435. - PubMed
    1. Tumor-induced osteomalacia. Florenzano P, Hartley IR, Jimenez M, Roszko K, Gafni RI, Collins MT. Calcif Tissue Int. 2021;108:128–142. - PubMed
    1. Tumor-induced osteomalacia: an up-to-date review. Hautmann AH, Hautmann MG, Kölbl O, Herr W, Fleck M. Curr Rheumatol Rep. 2015;17:512. - PubMed
    1. Tumor-induced osteomalacia: an important cause of adult-onset hypophosphatemic osteomalacia in China: report of 39 cases and review of the literature. Jiang Y, Xia WB, Xing XP, et al. J Bone Miner Res. 2012;27:1967–1975. - PubMed

Publication types

LinkOut - more resources