A phosphaturic mesenchymal tumor associated with oncogenic osteomalacia may be hard to detect. Recognition of the syndrome and persistence are the keys to successful therapy.
Barriers to detection:
(1) The tumors are often small.
(2) The tumors may be located in an occult location.
(3) The tumors may be mistaken for lymph nodes.
Localizing the tumor may involve:
(1) A careful evaluation of the skin surfaces and subcutaneous tissue for any nodules.
(2) If the physical examination is negative, then perform an MR skeletal survey. Look carefully at the facial bones and small bones of the hands and feet.
(3) If the MR scan is negative then perform scintigraphy after administration of indium-111 labeled pentetreotide (binds to somatostatin receptors in the tumor).
Total excision of the causative tumor should cause complete reversal of the metabolic abnormalities.
To read more or access our algorithms and calculators, please log in or register.
