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Head and Neck Pathology
Published in: Head and Neck Pathology 2/2016

01-06-2016 | Original Paper

Phosphaturic Mesenchymal Tumor: 2 New Oral Cases and Review of 53 Cases in the Head and Neck

Authors: Hiba Qari, Aya Hamao-Sakamoto, Clay Fuselier, Yi-Shing Lisa Cheng, Harvey Kessler, John Wright

Published in: Head and Neck Pathology | Issue 2/2016

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Abstract

Phosphaturic mesenchymal tumor (PMT) is a rare neoplasm that secretes fibroblast growth factor-23 (FGF-23) and causes oncogenic osteomalacia. It occurs in adults with equal gender distribution and the most common location is the lower extremities, followed by the head and neck. Besides osteomalacia, the clinical presentation includes bone pain and multiple bone fractures. Microscopic features consist of spindle cells, multinucleated giant cells, and calcifications embedded in a chondromyxoid matrix. Laboratory findings indicate normal calcium and parathyroid levels, hypophosphatemia, and increased levels of FGF-23 that usually revert to normal after surgical removal. Due to its rarity, the purpose of the study was to report 2 new oral cases of PMT and to review the literature in the head and neck. The first case occurred in the gingiva and had been present for 6 years. The second case was a recurrence of a previously diagnosed PMT in the right mandible that metastasized to the lung and soft tissue. The literature review included 53 cases in the head and neck. There was a predilection for extra-oral sites (76 %) compared to intra-oral sites (24 %) with paranasal sinuses considered the most common location (38 %) followed by the mandible (15 %). There were 9 recurrences that included 3 malignant cases indicating a potentially aggressive tumor. Due to the indeterminate biological behavior of PMT and its rarity, a comprehensive evaluation of medical, laboratory, radiographic, and histological findings are crucial for a definitive diagnosis and treatment.
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Metadata
Title
Phosphaturic Mesenchymal Tumor: 2 New Oral Cases and Review of 53 Cases in the Head and Neck
Authors
Hiba Qari
Aya Hamao-Sakamoto
Clay Fuselier
Yi-Shing Lisa Cheng
Harvey Kessler
John Wright
Publication date
01-06-2016
Publisher
Springer US
Published in
Head and Neck Pathology / Issue 2/2016
Electronic ISSN: 1936-0568
DOI
https://doi.org/10.1007/s12105-015-0668-3

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