Phosphaturic Mesenchymal Tumor: A Case Report

Abstract

Phosphaturic Mesenchymal Tumor (PMT) is a polymorphic group of extremely rare and usually benign, slow-growing tumors. PMT is frequently associated with tumor-induced osteomalacia (TIO), a paraneoplastic syndrome that manifests as renal phosphate wasting. The diagnosis is often delayed due to the non-specific nature of the symptoms and is also misdiagnosed due to histological overlap with other mesenchymal neoplasms. Serious disabilities may occur if they are not treated. Complete resection of the tumor is curative and leads to the normalization of biochemical abnormalities and inversion of symptoms. The majority of these tumors occur in the extremities (95%) with rare cases reported in the jaws. This patient presented to the Oral and Maxillofacial Surgery Department, Lady Reading Hospital Peshawar Pakistan with a recurrent PMT involving a mandible with a history of three months, which had already been misdiagnosed previously. Biochemical reports were normal as our case was diagnosed at a very early stage due to a prominent location and rapidly increasing size. Resection of the tumor was performed with a 1.5 cm safe margin. The mandibular reconstruction was then done with an L-type reconstruction plate fixed with bi-cortical screws on the remaining mandible on each side. Patient recovery was uneventful and he is now on follow up. At present, the patient remains well without any evidence of local recurrence.