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.