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Spinal phosphaturic mesenchymal tumors: a rare etiology causing tumor-induced osteomalacia-a review of experience at a UK tertiary referral center and literature review

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EUROPEAN SPINE JOURNAL
卷 -, 期 -, 页码 -

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SPRINGER
DOI: 10.1007/s00586-023-08031-6

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Phosphaturic; Mesenchymal; Tumor-induced osteomalacia; (68)GA-DOTA-TATE PET/CT scan; Hypophosphatemia; Fibroblast growth factor-23

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This article provides a comprehensive review of the management challenges associated with Spinal Phosphaturic Mesenchymal tumors (PMTs) and evaluates the surgical management outcomes for this rare entity linked to Tumor-induced osteolysis. The study aims to enhance the familiarity of treating physicians with the clinical features, diagnosis, and treatment options for Spinal PMTs. The retrospective analysis of electronic medical records reveals that surgical management of Spinal PMTs can effectively alleviate symptoms and restore phosphate levels. A multidisciplinary approach and continued vigilance are essential for early diagnosis, effective treatment, and long-term monitoring of patients affected by spinal PMTs.
Purpose This article aims to provide a comprehensive review of the management challenges associated with Spinal Phosphaturic Mesenchymal tumors (PMTs) and evaluates the surgical management outcomes for this rare entity linked to Tumor-induced osteolysis. The primary objective of this study is to enhance the familiarity of treating physicians with the clinical features, diagnosis, and treatment options for Spinal PMTs.Methods A retrospective analysis was conducted, reviewing electronic medical records of patients diagnosed with spinal PMTs at our hospital between January 2019 and December 2022. The data collected included demographic information, clinical presentation, radiological findings, surgical details, and follow-up outcomes.Results A total of three cases of Spinal PMTs causing Tumor-induced osteomalacia were identified. The diagnosis of Spinal PMTs presented challenges, with incidental detection often occurring during routine imaging. Surgical management was undertaken, resulting in successful symptom resolution and normalization of phosphate levels. The application of 68 Ga-DOTA-TATE PET/CT scans facilitated tumor localization, aiding in surgical planning. Spinal PMTs demonstrated a favorable response to surgical intervention.Conclusion Spinal PMTs play a significant role in Tumor-induced osteolysis, warranting timely and accurate diagnosis. Although diagnosing Spinal PMTs presents challenges, surgical management has proven to yield favorable outcomes, effectively alleviating symptoms and restoring phosphate levels. A multidisciplinary approach and continued vigilance are essential in ensuring early diagnosis, effective treatment, and long-term monitoring for patients affected by spinal PMTs.

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