Surgical and biochemical outcomes of phosphaturic mesenchymal tumors
causing tumor-induced osteomalacia in the head and neck region
Abstract
Objectives: We aimed to report the surgical outcomes of phosphaturic
mesenchymal tumors causing tumor-induced osteomalacia in the head and
neck. Design: A retrospective cohort study Setting: A tertiary care
academic hospital Methods: This study analyzed nine patients who
underwent surgical excision of phosphaturic mesenchymal tumors in the
head and neck region. The primary sites were two in the maxilla and
ethmoid sinus, and one in the intracranial, skull, parotid gland,
maxillary sinus, and nasal cavity in each patient. Outcomes were
compared with those in the extremities and trunk (n = 32). Results: Five
of nine patients (56%) developed residual disease/local recurrence
associated with low serum phosphate level after initial surgical
excision. At the last follow-up, the biochemical parameters were
normalized in four of the five patients after re-excision without any
medication. The local recurrence/residual disease risk was significantly
higher for the head and neck compared with the extremities and trunk
(56% vs. 25%, p = 0.048). The rate of remission (normalized serum
phosphate without medication) at final follow-up was similar in both
groups after re-excision (head and neck vs. extremities and trunk, 86%
vs. 73%, p = 0.827). Conclusions: Phosphaturic mesenchymal tumor
resection in the head and neck region was challenging because of its
complex anatomy and proximity to the brain or other crucial organs,
which was associated with high local recurrence/residual disease rate.
However, biological remission was achieved in the majority of the
patients after re-excision.