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Phosphaturic Mesenchymal Tumors from Head to Toe: Imaging Findings and Role of the Radiologist in Diagnosing Tumor-Induced Osteomalacia

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Abstract

Background

This study aimed at evaluating the imaging findings of phosphaturic mesenchymal tumors and tumor-induced osteomalacia and assess the clinical and biochemical profiles of patients with tumor-induced osteomalacia.

Materials and methods

Imaging findings in six patients with tumor-induced osteomalacia and histopathologically proven phosphaturic mesenchymal tumors were evaluated. Clinical and biochemical profiles of these patients were also assessed.

Results

Along with having a characteristic biochemical profile, patients with phosphaturic mesenchymal tumors also have certain imaging findings which can aid in the diagnosis such as increased uptake on DOTA PET-CT and homogeneous post-contrast enhancement on CT and MRI.

Conclusion

Patients with tumor-induced osteomalacia have characteristic symptoms, imaging and biochemical profiles. For radiologists, raising the suspicion of a phosphaturic mesenchymal tumor in patients with refractory hypophosphatemic osteomalacia as well as localizing the tumor on imaging is crucial, as complete excision of the tumor leads to resolution of the osteomalacia and the patient’s clinical symptoms.

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Authors and Affiliations

  1. Department of Radiology, Grant Medical College and Sir JJ Hospital, Mumbai, India

    Ameya S. Kawthalkar

  2. Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India

    Amit K. Janu & Kunal B. Gala

  3. Department of General Medicine, Topiwala Nair Medical College and BYL Nair Hospital, Mumbai, India

    Mrunmayee S. Deshpande

  4. Bone and Soft Tissue Services, Tata Memorial Hospital, Mumbai, India

    Ashish Gulia & Ajay Puri

Authors
  1. Ameya S. Kawthalkar
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  2. Amit K. Janu
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  3. Mrunmayee S. Deshpande
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  4. Kunal B. Gala
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  5. Ashish Gulia
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  6. Ajay Puri
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Contributions

Concepts: ASK, AKJ, MSD, KBG. Design: ASK, AKJ, MSD, KBG. Definition of intellectual content: ASK, AKJ, MSD. Literature search: ASK, AKJ, MSD. Clinical studies: ASK, AKJ, KBG. Experimental studies. Data acquisition: ASK. Data analysis: ASK, AKJ, MSD, KBG. Statistical analysis: ASK. Manuscript preparation: ASK. Manuscript editing: ASK, AKJ, MSD, KBG. Manuscript review: ASK, AKJ, MSD, KBG. Guarantor: ASK, AKJ.

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Correspondence to Amit K. Janu.

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Kawthalkar, A.S., Janu, A.K., Deshpande, M.S. et al. Phosphaturic Mesenchymal Tumors from Head to Toe: Imaging Findings and Role of the Radiologist in Diagnosing Tumor-Induced Osteomalacia. JOIO 54, 215–223 (2020). https://doi.org/10.1007/s43465-019-00005-5

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  • DOI: https://doi.org/10.1007/s43465-019-00005-5

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