title: Radiofrequency ablation, an effective modality of treatment in tumor-induced osteomalacia: a case series of three patients.
abstract: BACKGROUND
  Tumor-induced osteomalacia is curable if the tumors can be totally excised. However, when the tumors are present in locations that make surgery disproportionately risky, the need for less invasive strategies like radiofrequency ablation (RFA) is realized.
  
  
  METHODS
  We describe three patients with suspected tumor-induced osteomalacia who were treated in our department between 2006 and 2013 with tumors in surgically difficult locations and were subjected to single or multiple sessions of RFA. The response was documented in terms of symptomatic improvement, phosphorus normalization, and follow-up (99m)Technitium-labelled hydrazinonicotinyl-Tyr3-octreotide ((99m)Tc HYNIC TOC) scan.
  
  
  RESULTS
  Two of the three individuals, patient A (with a 1.5 × 1.2-cm lesion in the head of the right femur) and patient B (with a 1.3 × 1.2-cm lesion on the endosteal surface of the shaft of the left femur), achieved complete remission with single sessions of RFA. Three months after the procedure, (99m)Tc HYNIC TOC scans revealed the absence of uptake at the previous sites, corroborating with the clinical improvement and phosphorus normalization. Patient C had a large 5.6 × 6.5-cm complex lesion in the lower end of the left femur with irregular margins, loculations, and bone grafts placed in previous surgery. He failed to achieve remission after multiple sessions of RFA due to the complex nature of the lesion, although the tumor burden was reduced significantly as documented on serial (99m)Tc HYNIC TOC scans.
  
  
  CONCLUSIONS
  Although surgery remains the treatment of choice, RFA could be an effective, less invasive, and safe modality of treatment in judiciously selected patients.
authors: Department of Endocrinology (S.J., R.K.), Seth G. S. Medical College and King Edward Memorial Hospital, Parel, Mumbai, 400012, India; Department of Radiodiagnosis (N.S.She., S.Ku.), Tata Memorial Centre, Parel, Mumbai 400012, India; and Departments of Radiology (K.R., B.P.) and Endocrinology (H.K., A.B., S.Kh., S.B., V.S.J., A.R.L., T.B., N.S.Sha.), Seth G. S. Medical College and King Edward Memorial Hospital, Parel, Mumbai, 400012, India.
authors: Swati
authors: S
authors: Jadhav
authors: Rajeev
authors: R
authors: Kasaliwal
authors: Nitin S
authors: NS
authors: Shetty
authors: Suyash
authors: S
authors: Kulkarni
authors: Krantikumar
authors: K
authors: Rathod
authors: Bhavesh
authors: B
authors: Popat
authors: Harshal
authors: H
authors: Kakade
authors: Amol
authors: A
authors: Bukan
authors: Shruti
authors: S
authors: Khare
authors: Sweta
authors: S
authors: Budyal
authors: Varsha S
authors: VS
authors: Jagtap
authors: Anurag R
authors: AR
authors: Lila
authors: Tushar
authors: T
authors: Bandgar
authors: Nalini S
authors: NS
authors: Shah
mesh_terms: D000328:Adult; D001706:Biopsy; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005266:Femoral Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009372:Neoplasms, Connective Tissue / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D010018:Osteomalacia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D010257:Paraneoplastic Syndromes / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed