title: Surgical treatment of tumor-induced osteomalacia: a retrospective review of 40 cases with extremity tumors.
abstract: BACKGROUND
  Tumor-induced osteomalacia (TIO) is a rare syndrome typically caused by mesenchymal tumors. It has been shown that complete tumor resection may be curative. However, to our knowledge, there has been no report of a large cohort to exam different surgical approaches. This study was aimed to assess outcomes of different surgical options of patients with tumor-induced osteomalacia at a single institution.
  
  
  METHODS
  Patients with extremity tumors treated in our hospital from January, 2004 to July, 2012 were identified. The minimum follow-up period was 12 months. Patient's demography, tumor location, preoperative preparation, type of surgeries were summarized, and clinical outcomes were recorded. Successful treatment was defined as significant symptom improvement, normal serum phosphorus and significant improvement or normalization of bone mineral density at the last follow-up. Differences between patients with soft tissue tumors and bone tumors were compared.
  
  
  RESULTS
  There were 40 (24 male and 16 female) patients identified, with an average age of 44 years. The tumors were isolated in either soft tissue (25 patients) or bone (12 patients) and combined soft tissue and bone invasion was observed in 3 patients. For the primary surgery, tumor resection and tumor curettage were performed. After initial surgical treatment, six patients then received a second surgery. Four patients were found to have malignant tumors base on histopathology. With a minimum follow-up period of 12 months, 80% of patients (32/40) were treated successfully, including 50% of patients (2/4) with malignant tumors. Compared to patients with bone tumor, surgical results were better in patient with soft tissue tumor.
  
  
  CONCLUSIONS
  Surgical treatment was an effective way for TIO. Other than tumor curettage surgery, tumor resection is the preferred options for these tumors.
authors: Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng District Shuaifuyuan No.1, Beijing, 100730, China. sunzhijian258@163.com.
authors: Zhi-jian
authors: ZJ
authors: Sun
authors: Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng District Shuaifuyuan No.1, Beijing, 100730, China. jinjin9010@126.com.
authors: Jin
authors: J
authors: Jin
authors: Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng District Shuaifuyuan No.1, Beijing, 100730, China. qiugx@medmail.com.
authors: Gui-xing
authors: GX
authors: Qiu
authors: Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng District Shuaifuyuan No.1, Beijing, 100730, China. gp4370@hotmail.com.
authors: Peng
authors: P
authors: Gao
authors: Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng District Shuaifuyuan No.1, Beijing, 100730, China. liuyongxh@163.com.
authors: Yong
authors: Y
authors: Liu
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002681:China; D003475:Curettage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010018:Osteomalacia / Q000175:diagnosis / Q000209:etiology*; D010027:Osteotomy; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012983:Soft Tissue Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity; D055815:Young Adult