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Case Reports
. 2022 Nov;12(11):28-33.
doi: 10.13107/jocr.2022.v12.i11.3402.

Phosphaturic Mesenchymal Tumor-induced Osteomalacia Masquerading as an Orthopedic Polytrauma Patient: A Case Report and Review of the Literature

Abrianna S Robles  1 , Zachary A Rockov  1 , Earl W Brien  1 , Milton Thomas Michael Little  1
Affiliations
Case Reports

Phosphaturic Mesenchymal Tumor-induced Osteomalacia Masquerading as an Orthopedic Polytrauma Patient: A Case Report and Review of the Literature

Abrianna S Robles et al. J Orthop Case Rep. 2022 Nov.

Abstract

Introduction: Phosphaturic mesenchymal tumor (PMT) is a rare benign tumor (500 cases to date) that can present in combination with a paraneoplastic syndrome called tumor-induced osteomalacia (TIO). To the best of our knowledge, it is the first case to date that presented as an orthopedic trauma patient.

Case report: This is a case of a 61-year-old male who initially presented as a polytrauma patient, but further investigation revealed a PMT causing TIO. This report describes his initial diagnosis and management from 2015 to 2021.

Conclusion: TIO resultant of PMT may lead to severe bone pain, impending fractures, and delayed or misdiagnosis. This case demonstrates the importance of careful diagnosis and a team-based approach to managing PMT and its sequelae.

Keywords: Pathological fracture; phosphaturic mesenchymal tumor; tumor-induced osteomalacia.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Presentation films (a) Left hip anteroposterior (AP), (b) Left hip lateral, (c) Left knee AP, (d) Left knee lateral, (e) Right humerus AP, (f) Right hip AP, (g) Right hip lateral, (h) Right knee AP, (i) Right knee lateral, and (j) Right humerus lateral.
Figure 2
Figure 2
Final pathology report from right humerus showing bland spindle cells in lobulated pattern.
Figure 3
Figure 3
3-month post-operative films (a) Left hip anteroposterior (AP), (b) Left hip lateral, (c) Left knee AP (d) Left knee lateral, (e) Right humerus AP, (f) Right hip AP, (g) Right hip lateral, (h) Right knee AP, (i) Right knee lateral, and (j) Right humerus lateral.
Figure 4
Figure 4
6-year post-operative films (a) Left hip anteroposterior (AP), (b) Left hip lateral, (c) Left knee AP (d) Left knee lateral, (e) Right humerus AP, (f) Right hip AP, (g) Right hip lateral, (h) Right knee AP, (i) Right knee lateral, and (j) Right humerus lateral.
See this image and copyright information in PMC

References

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