title: Successful CT guided cryoablation of phosphaturic mesenchymal tumor in the soft tissues causing tumor-induced osteomalacia: a case report.
abstract: We report the case of a 25-year-old male patient with tumor-induced osteomalacia from a 1.8-cm phosphaturic mesenchymal tumor in the right distal thigh, who was treated at our institution with a single session of CT-guided cryoablation in December 2015, which resulted in biochemical and clinical resolution. We present the clinical history, physical examination, biochemistry, functional imaging, anatomic characterization, and follow-up for clinical outcome. The response to treatment was documented in terms of normalization of serum fibroblastic growth factor 23 (FGF23) and phosphorous levels, symptomatic improvement, as well as normalization of bone mineralization on femur radiographs 3 months after the procedure. Although the first-line treatment for phosphaturic mesenchymal tumor-induced osteomalacia is wide surgical excision, CT-guided cryoablation widens the array of treatment options, especially in those patients who decline surgery or who are otherwise poor surgical candidates.
authors.affiliation: Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA.
authors.forename: Sophie
authors.initials: S
authors.lastname: Cowan
authors.affiliation: Department of Orthopaedic Surgery, Division of Musculoskeletal Oncology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 3B, Boston, MA, 02114, USA.
authors.forename: Santiago A
authors.initials: SA
authors.lastname: Lozano-Calderon
authors.affiliation: Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, Gray-Bigelow 298, Boston, MA, 02114, USA.
authors.forename: Raul N
authors.initials: RN
authors.lastname: Uppot
authors.affiliation: Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Warren 219, Boston, MA, 02114, USA.
authors.forename: Dipti
authors.initials: D
authors.lastname: Sajed
authors.affiliation: Department of Radiology, Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, Yawkey 6E, Boston, MA, 02114, USA. ajhuang@mgh.harvard.edu.
authors.forename: Ambrose J
authors.initials: AJ
authors.lastname: Huang
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood / Q000652:urine; D015519:Bone Density; D003452:Cryosurgery / Q000379:methods*; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D006801:Humans; D008297:Male; D008637:Mesenchymoma / Q000150:complications* / Q000601:surgery*; D010018:Osteomalacia / Q000209:etiology*; D015641:Radiography, Interventional; D012983:Soft Tissue Neoplasms / Q000150:complications* / Q000601:surgery*; D013848:Thigh
chemical_list: D014408:Biomarkers, Tumor; C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23
keywords: Cryoablation; Phosphaturic mesenchymal tumor; Tumor-induced osteomalacia