Delayed diagnosis of occult phosphaturic mesenchymal tumor in the foot

Joana Correia, MD; Marino Machado, MD; Rui Gonçalves, MD; Frederik Jonge, MD; Manuela Micaelo, MD; Carlos Pedrosa, MD; José Portela, MD

Radiology Case Reports (Jun 2021)

Delayed diagnosis of occult phosphaturic mesenchymal tumor in the foot

Joana Correia, MD,
Marino Machado, MD,
Rui Gonçalves, MD,
Frederik Jonge, MD,
Manuela Micaelo, MD,
Carlos Pedrosa, MD,
José Portela, MD

Affiliations

Joana Correia, MD: Department of Orthopedic Surgery and Traumatology, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Rua da Beneficência N. 8, 1069-166, Lisbon, Portugal; Corresponding author.
Marino Machado, MD: Department of Orthopedic Surgery and Traumatology, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Rua da Beneficência N. 8, 1069-166, Lisbon, Portugal
Rui Gonçalves, MD: Department of Orthopedic Surgery and Traumatology, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Rua da Beneficência N. 8, 1069-166, Lisbon, Portugal
Frederik Jonge, MD: Department of Nuclear Medicine, Hospital Lusíadas Lisboa, R.Abílio Mendes 12, 1500-458, Lisbon, Portugal
Manuela Micaelo, MD: Department of Rheumatology, Hospital Lusíadas Lisboa, R.Abílio Mendes 12, 1500-458, Lisbon, Portugal
Carlos Pedrosa, MD: Department of Orthopedic Surgery and Traumatology, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Rua da Beneficência N. 8, 1069-166, Lisbon, Portugal
José Portela, MD: Department of Orthopedic Surgery and Traumatology, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Rua da Beneficência N. 8, 1069-166, Lisbon, Portugal

Journal volume & issue: Vol. 16, no. 6
pp. 1355 – 1362

Abstract

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Phosphaturic mesenchymal tumors are the main cause of tumor-induced osteomalacia, a distinctive paraneoplastic syndrome mediated by overproduction of fibroblast growth factor 23, that leads to renal phosphate wasting and hypophosphatemia. Diagnosis of this mesenchymal tumors is difficult and usually delayed for several years. We present the case of a 70-years-old-male with generalized bone pain, multiple pathological fractures and persistent hypophosphatemia, diagnosed with tumor-induced osteomalacia after 4 years of the onset of symptoms. The tumor was localized in the forefoot using Gallium 68-DOTANOC positron emission tomography-computed tomography and successfully surgically treated. This case report highlights the importance of recognizing these rare tumors, as early diagnosis can prevent long-term morbidity.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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