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.