A pediatric case of a phosphaturic mesenchymal tumor: A “nonphosphaturic” variant in the infratemporal skull base

Objectives: To describe a rare case of infratemporal phosphaturic mesenchymal tumor (PMT), a “nonphosphaturic” variant in the infratemporal skull base, in a 5-year-old boy. Methods: This was a retrospective study of the patient's clinical and biochemical features, computed tomography (CT), maxi...

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Autores principales: Jin-Feng Liang, Zu-yun Li, Dong-Xiao Nong, An-zhou Tang
Formato: article
Lenguaje:EN
Publicado: Elsevier 2021
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Acceso en línea:https://doaj.org/article/c85f9c74963948f482557806ba4d870c
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Sumario:Objectives: To describe a rare case of infratemporal phosphaturic mesenchymal tumor (PMT), a “nonphosphaturic” variant in the infratemporal skull base, in a 5-year-old boy. Methods: This was a retrospective study of the patient's clinical and biochemical features, computed tomography (CT), maxillofacial magnetic resonance imaging (MRI), histopathology as well as surgical treatment and follow-up. Results: The boy suffered from a right preauricular mass and ipsilateral hearing loss. Temporal bone CT and maxillofacial MRI demonstrated a circumscribed infratemporal skull base lesion. Histomorphologically, the lesion demonstrated typical microscopic features of PMTs and was positive for vimentin, smooth muscle actin, and FGF-23. However, there was no clinical or biochemical evidence of tumor-induced osteomalacia (TIO), and ultimately a diagnosis of a “nonphosphaturic” variant of PMTs was made. No postoperative recurrence was observed during follow-up. Conclusions: PMTs are rare and have a low incidence among children. They are histologically distinctive tumors associated with phosphaturia and TIO. So-called “nonphosphaturic” variants, occurring without known phosphaturia, are even rarer. Pathologists and clinicians need to be aware of the presence of a PMT with an absence of osteomalacia symptoms. Wide surgical resection and long-term follow-up are necessary. Intraoperative functional and aesthetic concerns should be emphasized as well, particularly in pediatric patients.