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Head and Neck Pathology

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14.11.2015 | Original Paper

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

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

Erschienen in: Head and Neck Pathology | Ausgabe 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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Titel: Phosphaturic Mesenchymal Tumor: 2 New Oral Cases and Review of 53 Cases in the Head and Neck
verfasst von: Hiba Qari
Aya Hamao-Sakamoto
Clay Fuselier
Yi-Shing Lisa Cheng
Harvey Kessler
John Wright
Publikationsdatum: 14.11.2015
Verlag: Springer US
Erschienen in: Head and Neck Pathology / Ausgabe 2/2016
Elektronische ISSN: 1936-0568
DOI: https://doi.org/10.1007/s12105-015-0668-3

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