Sun Zhi-jian, Jin Jin, Qiu Gui-xing, Gao Peng, Liu Yong
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.
BMC Musculoskelet Disord. 2015 Feb 26;16:43. doi: 10.1186/s12891-015-0496-3.
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.
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.
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.
Surgical treatment was an effective way for TIO. Other than tumor curettage surgery, tumor resection is the preferred options for these tumors.
肿瘤诱导的骨软化症（TIO）是一种罕见的综合征，通常由间充质肿瘤引起。已表明完整切除肿瘤可能治愈。然而，据我们所知，尚无关于大型队列研究不同手术方法的报道。本研究旨在评估单一机构中肿瘤诱导的骨软化症患者不同手术选择的结果。
确定2004年1月至2012年7月在我院接受治疗的四肢肿瘤患者。最短随访期为12个月。总结患者的人口统计学、肿瘤位置、术前准备、手术类型，并记录临床结果。成功治疗定义为症状明显改善、血清磷正常以及最后一次随访时骨密度明显改善或恢复正常。比较软组织肿瘤和骨肿瘤患者之间的差异。
共确定40例患者（24例男性和16例女性），平均年龄44岁。肿瘤孤立于软组织（25例患者）或骨（12例患者），3例患者观察到软组织和骨联合侵犯。对于初次手术，进行了肿瘤切除和肿瘤刮除术。初次手术治疗后，6例患者接受了二次手术。4例患者经组织病理学检查发现患有恶性肿瘤。最短随访期为12个月，80%的患者（32/40）治疗成功，包括50%的恶性肿瘤患者（2/4）。与骨肿瘤患者相比，软组织肿瘤患者的手术结果更好。
手术治疗是TIO的有效方法。除肿瘤刮除术外，肿瘤切除术是这些肿瘤的首选方案。
