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Clinical, morphological and immunohistochemical analysis of 13 cases of phosphaturic mesenchymal tumor - A holistic diagnostic approach.
- Source :
-
Annals of diagnostic pathology [Ann Diagn Pathol] 2021 Oct; Vol. 54, pp. 151783. Date of Electronic Publication: 2021 Jul 02. - Publication Year :
- 2021
-
Abstract
- Background: Phosphaturic mesenchymal tumor-mixed connective tissue (PMT-MCT) is a rare tumor characterized clinically by presence of tumor-induced osteomalacia (TIO), subsequent to elevated fibroblastic growth factor 23 (FGF23) levels. This study aims to analyse the morphological spectrum of PMT along with clinico-pathological correlation and immunophenotype profile of this rare tumor.<br />Materials and Methods: Detailed histological analysis of all tumors presenting with TIO over past 7 years was done retrospectively. Immunohistochemistry was performed in all cases for SATB2, STAT6, CD34, FGF23, ERG, S100 and smooth muscle actin (SMA).<br />Results: A total of 13 cases were analysed (8 female and 5 male) with mean age of 39.8 years. Five cases were arising from bone while 4 each from soft tissue and nasal cavity/paranasal sinus. All presented with hypophosphatemia, hyperphosphaturia, elevated serum FGF23 and features suggestive of osteomalacia. Histological examination revealed basophilic 'grungy' calcification seen in 7 (53.8%), osteoid formation in 8 (61.5%), chondroid matrix in 4 (30.8%), adipose tissue in 6 (46.2%), osteoclast-like giant cells in 9 (69.2%) and hemangiopericytomatous (HPC like) blood vessels in 7 cases (53.8%). HPC like vessels and adipose tissue were more common in nasal tumors while calcification was more common in tumors arising from bone. All cases showed immunoreactivity for SATB2 and clinical improvement following resection except one case with residual tumor.<br />Conclusion: PMT shows varied histological pattern with various matrix components depending on the site of the tumor. Serum FGF-23 is a useful adjunctive marker for diagnosis.<br /> (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Biomarkers, Tumor analysis
Female
Humans
Hypophosphatemia diagnosis
Hypophosphatemia metabolism
Hypophosphatemia pathology
Immunohistochemistry methods
Immunophenotyping methods
Male
Mesenchymoma diagnosis
Middle Aged
Osteomalacia diagnosis
Osteomalacia pathology
Paraneoplastic Syndromes diagnosis
Paraneoplastic Syndromes pathology
Retrospective Studies
Soft Tissue Neoplasms diagnosis
Soft Tissue Neoplasms metabolism
Mesenchymoma metabolism
Mesenchymoma pathology
Osteomalacia metabolism
Paraneoplastic Syndromes metabolism
Soft Tissue Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8198
- Volume :
- 54
- Database :
- MEDLINE
- Journal :
- Annals of diagnostic pathology
- Publication Type :
- Academic Journal
- Accession number :
- 34329884
- Full Text :
- https://doi.org/10.1016/j.anndiagpath.2021.151783