3.2 Surgical and biochemical outcomes
Of the nine patients, four (44%) underwent a biopsy before definitive
surgery, which confirmed the PMT diagnosis. Patients underwent surgical
excision of the tumor with R0 (n = 1) or R1 margin (n = 8). There was no
surgical complication. Residual/local recurrent tumors with low serum
phosphate were seen in five patients (56%) after initial surgical
resection, including four residual and one local recurrent tumor. Of
these, four patients (80%) underwent tumor re-excision, and serum
phosphate and FGF23 levels were normalized without any medication at the
final follow-up. Residual/local recurrent tumors were detected at median
19 months (range, 9–80 moths) form initial resection by imaging
studies. At the time of the last follow-up, eight patients (89%) were
still alive, while one died from an acute myocardial infarction. The
four patients (44%) were continuously recurrent tumor-free after the
initial surgery. Only one patient (11%) was living with a recurrent
tumor after surgical excision and taking oral phosphate and activated
vitamin D.