Base de dados : MEDLINE
Pesquisa : C04.557.450.565 [Categoria DeCS]
Referências encontradas : 730 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 73 ir para página                         

  1 / 730 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29390586
[Au] Autor:Wu W; Wang C; Ruan J; Chen F; Li N; Chen F
[Ad] Endereço:Department of Orthopedics.
[Ti] Título:A case report of phosphaturic mesenchymal tumor-induced osteomalacia.
[So] Source:Medicine (Baltimore);96(51):e9470, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Tumor-induced osteomalacia (TIO) is a rare and often misdiagnosed syndrome. Surgical resection is currently the first line treatment for TIO. PATIENT CONCERNS: Here we report the case of a 49-year-old woman presented with intermittent pain in the right chest and bilateral hip that had persisted for over two years. DIAGNOSES: She was diagnosed of TIO caused by a phosphaturic mesenchymal tumor based on the following examinations. Laboratory tests revealed high serum alkaline phosphatase, high urinary phosphorus, hypophosphatemia and normal serum calcium levels. 18-FDG PET/CT indicated a systemic multi-site symmetrical pseudo fracture and a tumor in the 7th right rib. INTERVENTIONS: Curettage of the tumor was performed, and pathological analysis also confirmed our diagnoses as a phosphaturic mesenchymal tumor. OUTCOMES: At seven months post-surgery, the symptoms were relieved, proximal muscle strength was improved and serum levels of phosphorus and alkaline phosphatase normalized. The bilateral femoral neck and bilateral pubic bone fractures were blurred in the pelvic plain X-ray, suggesting that the fracture was healing. LESSONS: This case report strengthened the importance of recognition of this rare disease to avoid delay of diagnosis and surgical removal of the causative tumor is recommended.
[Mh] Termos MeSH primário: Neoplasias Ósseas/complicações
Hipofosfatemia Familiar/etiologia
Neoplasias de Tecido Conjuntivo/etiologia
Osteomalacia/etiologia
[Mh] Termos MeSH secundário: Fosfatase Alcalina/sangue
Neoplasias Ósseas/diagnóstico
Neoplasias Ósseas/diagnóstico por imagem
Feminino
Seres Humanos
Meia-Idade
Tomografia por Emissão de Pósitrons
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.1.3.1 (Alkaline Phosphatase)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009470


  2 / 730 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28614212
[Au] Autor:Agaimy A; Michal M; Chiosea S; Petersson F; Hadravsky L; Kristiansen G; Horch RE; Schmolders J; Hartmann A; Haller F; Michal M
[Ad] Endereço:*Institute of Pathology ††Department of Hand & Plastic Surgery, University Hospital, Erlangen **Institute of Pathology ‡‡Department of Orthopedic & Traumatology, Section for Tumor Orthopedics, University Hospital, Bonn, Germany †Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Prague ‡Biomedical Center of the Faculty of Medicine in Pilsen, Pilsen, Czech Republic §Department of Pathology, University of Pittsburgh Medical Center, Presbyterian Hospital, Pittsburgh, PA ∥Department of Pathology, National University Health System, Singapore ¶Department of Pathology, 3rd Medical Faculty in Prague, Charles University, Prague, Czech Republic.
[Ti] Título:Phosphaturic Mesenchymal Tumors: Clinicopathologic, Immunohistochemical and Molecular Analysis of 22 Cases Expanding their Morphologic and Immunophenotypic Spectrum.
[So] Source:Am J Surg Pathol;41(10):1371-1380, 2017 Oct.
[Is] ISSN:1532-0979
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Phosphaturic mesenchymal tumor (PMT) is a rare neoplasm of uncertain histogenesis that has been linked to tumor-induced osteomalacia (TIO) since 1959. The neoplastic cells produce increased amount of FGF23 which results in TIO via uncontrolled renal loss of phosphate (phosphaturia), and consequently diminished bone mineralization. To date, ∼300 cases have been reported. Although there is increasing evidence that PMT can be diagnosed by reproducible histopathologic features, firm diagnosis has been often restricted to cases associated with TIO and, hence, diagnosis of "nonphosphaturic variants" remained challenging. Recently, FGFR1/FN1 gene fusions were detected in roughly half of cases. We herein reviewed the clinicopathologic features of 22 PMTs (15 cases not published before), stained them with an extended immunohistochemical marker panel and examined them by fluorescence in situ hybridization for FGFR1 gene fusions. Patients were 12 males and 9 females (one of unknown sex) aged 33 to 83 years (median: 52 y). Lesions affected the soft tissues (n=11), bones (n=6), sinonasal tract (n=4), and unspecified site (n=1). Most lesions originated in the extremities (9 in the lower and 4 in the upper extremities). Acral sites were involved in 10 patients (6 foot/heel, 3 fingers/hands, and 1 in unspecified digit). Phosphaturia and TIO were recorded in 10/11 and 9/14 patients with detailed clinical data, respectively. Limited follow-up (5 mo to 14 y; median: 16 mo) was available for 14 patients. Local recurrence was noted in one patient and metastasis in another patient. Histologically, 11 tumors were purely of conventional mixed connective tissue type, 3 were chondromyxoid fibroma-like, 2 were hemangio-/glomangiopericytoma-like with giant cells, and 1 case each angiomyolipoma-like and reparative giant cell granuloma-like. Four tumors contained admixture of patterns (predominantly cellular with variable conventional component). Immunohistochemistry showed consistent expression of CD56 (11/11; 100%), ERG (19/21; 90%), SATB2 (19/21; 90%), and somatostatin receptor 2A (15/19; 79%), while other markers tested negative: DOG1 (0/17), beta-catenin (0/14), S100 protein (0/14), and STAT6 (0/7). FGFR1 fluorescence in situ hybridization was positive in 8/17 (47%) evaluable cases. These results add to the phenotypic delineation of PMT reporting for the first time consistent expression of SATB2 and excluding any phenotypic overlap with solitary fibrous tumor or sinonasal glomangiopericytoma. The unifying immunophenotype of the neoplastic cells irrespective of the histologic pattern suggests a specific disease entity with diverse morphotypes/variants rather than different neoplasms unified by TIO.
[Mh] Termos MeSH primário: Mesenquimoma/genética
Mesenquimoma/patologia
Neoplasias de Tecido Conjuntivo/genética
Neoplasias de Tecido Conjuntivo/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Imuno-Histoquímica
Imunofenotipagem
Masculino
Meia-Idade
Técnicas de Diagnóstico Molecular
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE
[do] DOI:10.1097/PAS.0000000000000890


  3 / 730 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28545150
[Au] Autor:Zhu W; Ma Q; Bian Y; Zhuang Q; Xia Z; Jin J; Weng X
[Ad] Endereço:Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
[Ti] Título:Total hip/knee arthroplasty in the treatment of tumor-induced osteomalacia patients: More than 1 year follow-up.
[So] Source:PLoS One;12(5):e0177835, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tumor-induced osteomalacia (TIO) may result in a better prognosis after complete resection of the causative neoplasm. However, tumors located proximal to the articular surface of the metaphysis remain largely uninvestigated. METHODS: A retrospective study of sixteen patients was undertaken to evaluate treatment of tumors with joint arthroplasty and tumor resection. The bone metabolism index, hip/knee joint function, arthroplasty complications and symptoms were followed up for at least 12 months in each patient. RESULTS: All patients presented with neoplasms situated in the articular surface of the metaphysis, with 13 cases undergoing hip arthroplasty and 3 undergoing knee arthroplasty. Treatment of the tumors with joint arthroplasty and tumor resection significantly and rapidly ameliorate bone metabolism indexes in patients with TIO (p<0.01), with no identified tumor recurrence. The joint function evaluation score was improved in 15 patients (93.75%). Complications in these patients included post-operative pain, joint squeaking and secondary hyperparathyroidism. CONCLUSIONS: Joint arthroplasty that includes tumor-expanding resection appears to be a safe and appropriate method for the treatment of TIO patients with a neoplasm located in the metaphysis proximal to the articular surface. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Artroplastia de Quadril/métodos
Artroplastia do Joelho/métodos
Neoplasias de Tecido Conjuntivo/cirurgia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Neoplasias de Tecido Conjuntivo/patologia
Prognóstico
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0177835


  4 / 730 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28445300
[Au] Autor:Qiu S; Cao LL; Qiu Y; Yan P; Li ZX; Du J; Sun LM; Zhang QF
[Ad] Endereço:aDepartment of Orthopedic Surgery bDepartment of Medical Oncology cDepartment of Ultrasonography, the First Affiliated Hospital of China Medical University, Shenyang dDepartment of Pathology, Fushun Hospital of Traditional Chinese Medicine, Fushun eDepartment of Radiology and Key Laboratory of Diagnostic Imaging and Interventional Radiology, the First Affiliated Hospital of China Medical University fDepartment of Pathology, the First Affiliated Hospital and College of Basic Medical Sciences of China Medical University, Shenyang, PR China.
[Ti] Título:Malignant phosphaturic mesenchymal tumor with pulmonary metastasis: A case report.
[So] Source:Medicine (Baltimore);96(17):e6750, 2017 Apr.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Phosphaturic mesenchymal tumor (PMT) is a new tumor entity of soft tissue and bone tumor recently accepted by the World Health Organization, which typically causes the paraneoplastic syndrome of tumor-induced osteomalacia (TIO). The majority of PMTs follow a benign clinical course and local recurrence occurs in < 10% of cases, malignant PMTs with distant organ metastasis are extremely uncommon. PATIENT CONCERNS: We reported a 41-year-old woman who was diagnosed with PMT 10 years ago with a repeated recurrence and pulmonary metastasis. DIAGNOSES: Based on clinical manifestations, MRI scan, serum biochemical indicators evaluation, followed by histopathological examination, the patient was diagnosed as malignant PMT with pulmonary metastasis. INTERVENTIONS: The patient was treated with calcium, phosphorus, and vitamin D after surgical resection and measured the serum ion concentrations every 3 months. OUTCOMES: The patient had a favorable outcome for 10 months without recurrence. LESSONS: PMTs lack of characteristic histological morphology, some recurrence cases may appear benign morphologically; the malignant PMTs are easily overlooked. Patients with PMT should be carefully evaluated and monitored, in order to early identify its malignant potential.
[Mh] Termos MeSH primário: Neoplasias Ósseas/patologia
Neoplasias Hepáticas/diagnóstico
Neoplasias Pulmonares/secundário
Mesenquimoma/diagnóstico
Neoplasias de Tecido Conjuntivo/patologia
[Mh] Termos MeSH secundário: Adulto
Neoplasias Ósseas/diagnóstico
Neoplasias Ósseas/terapia
Diagnóstico Diferencial
Feminino
Seres Humanos
Hipofosfatemia/etiologia
Neoplasias Hepáticas/patologia
Neoplasias Hepáticas/secundário
Neoplasias Pulmonares/diagnóstico
Neoplasias Pulmonares/terapia
Mesenquimoma/patologia
Mesenquimoma/secundário
Neoplasias de Tecido Conjuntivo/diagnóstico
Neoplasias de Tecido Conjuntivo/terapia
Osteomalacia/etiologia
Síndromes Paraneoplásicas/diagnóstico
Síndromes Paraneoplásicas/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170601
[Lr] Data última revisão:
170601
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006750


  5 / 730 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28250301
[Au] Autor:Takashi Y; Kinoshita Y; Ito N; Taguchi M; Takahashi M; Egami N; Tajima S; Nangaku M; Fukumoto S
[Ad] Endereço:Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Japan.
[Ti] Título:Tumor-induced Osteomalacia Caused by a Parotid Tumor.
[So] Source:Intern Med;56(5):535-539, 2017.
[Is] ISSN:1349-7235
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:A 77-year-old man was suspected of having tumor-induced osteomalacia (TIO) because of hypophosphatemia (1.9 mg/dL) and elevated serum fibroblast growth factor 23 (FGF23) level (186.9 pg/mL). We detected a tumor in his left parotid gland, and the FGF23 level in the left external jugular vein indicated that the tumor overproduced FGF23. After the removal of the tumor, the serum FGF23 level rapidly decreased, and the serum phosphate normalized. This is the first case of TIO caused by a tumor in a parotid gland. This case indicates that the responsible tumors for TIO can be quite diverse.
[Mh] Termos MeSH primário: Neoplasias de Tecido Conjuntivo/etiologia
Neoplasias Parotídeas/complicações
[Mh] Termos MeSH secundário: Idoso
Biomarcadores Tumorais/sangue
Fatores de Crescimento de Fibroblastos/sangue
Seres Humanos
Hipofosfatemia/etiologia
Imagem por Ressonância Magnética
Masculino
Neoplasias de Tecido Conjuntivo/diagnóstico por imagem
Síndromes Paraneoplásicas/diagnóstico por imagem
Síndromes Paraneoplásicas/etiologia
Neoplasias Parotídeas/diagnóstico por imagem
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons
Cintilografia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (fibroblast growth factor 23); 62031-54-3 (Fibroblast Growth Factors)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.2169/internalmedicine.56.7565


  6 / 730 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28214470
[Au] Autor:Nagai T; Kamimura T; Itou K; Fujii M; Tsukino H; Mukai S; Akiyama Y; Kataoka H; Kamoto T
[Ad] Endereço:Department of Urology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, Japan.
[Ti] Título:Myopericytoma in urinary bladder: a case report.
[So] Source:J Med Case Rep;11(1):46, 2017 Feb 19.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Myopericytoma is reported to occur mainly in the skin and superficial soft tissue of the extremities. In contrast, occurrence in the urinary bladder is extremely rare. CASE PRESENTATION: We describe a 75-year-old Japanese man who developed a submucosal tumor at the right trigone of his bladder that led to interference with the discharge of right ureteral calculus. No invasive growth was observed by magnetic resonance imaging. Transurethral resection was successfully performed; histopathological analysis revealed perivascular proliferation of spindle-shaped to oval-shaped, cytologically bland tumor cells with eosinophilic cytoplasm. On immunohistochemical examination, the tumor cells were positive for alpha-smooth muscle actin, desmin, CD34 and h-caldesmon. CONCLUSION: Cystoscopic and pathological findings were compatible with a diagnosis of myopericytoma of the urinary bladder.
[Mh] Termos MeSH primário: Miofibroma/patologia
Neoplasias de Tecido Conjuntivo/patologia
Neoplasias da Bexiga Urinária/patologia
Bexiga Urinária/patologia
[Mh] Termos MeSH secundário: Idoso
Diagnóstico Diferencial
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Miofibroma/diagnóstico
Neoplasias de Tecido Conjuntivo/diagnóstico
Radiografia
Tomografia Computadorizada por Raios X
Neoplasias da Bexiga Urinária/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170720
[Lr] Data última revisão:
170720
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170220
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1226-2


  7 / 730 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28193220
[Au] Autor:Arai R; Onodera T; Terkawi MA; Mitsuhashi T; Kondo E; Iwasaki N
[Ad] Endereço:Departments of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan. ryutaaraisti@yahoo.co.jp.
[Ti] Título:A rare case of multiple phosphaturic mesenchymal tumors along a tendon sheath inducing osteomalacia.
[So] Source:BMC Musculoskelet Disord;18(1):79, 2017 Feb 13.
[Is] ISSN:1471-2474
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia, reduction of 1,25-dihydroxyl vitamin D, and bone calcification disorders. Tumors associated with TIO are typically phosphaturic mesenchymal tumors that are bone and soft tissue origin and often present as a solitary tumor. The high production of fibroblast growth factor 23 (FGF23) by the tumor is believed to be the causative factor responsible for the impaired renal tubular phosphate reabsorption, hypophosphatemia and osteomalacia. Complete removal of the tumors by surgery is the most effective procedure for treatment. Identification of the tumors by advanced imaging techniques is difficult because TIO is small and exist within bone and soft tissue. However, systemic venous sampling has been frequently reported to be useful for diagnosing TIO patients. CASE PRESENTATION: We experienced a case of 39-year-old male with diffuse bone pain and multiple fragility fractures caused by multiple FGF23-secreting tumors found in the hallux. Laboratory testing showed hypophosphatemia due to renal phosphate wasting and high levels of serum FGF23. Contrast-enhanced MRI showed three soft tissue tumors and an intraosseous tumor located in the right hallux. Systemic venous sampling of FGF23 revealed an elevation in the right common iliac vein and external iliac vein, which suggested that the tumors in the right hallux were responsible for overproduction of FGF23. Thereafter, these tumors were surgically removed and subjected to histopathological examinations. The three soft tissue tumors were diagnosed as phosphaturic mesenchymal tumors, which are known to be responsible for TIO. The fourth tumor had no tumor structure and was consisting of hyaline cartilage and bone tissue. Immediately after surgery, we noted a sharply decrease in serum level of FGF23, associated with an improved hypophosphatemia and a gradual relief of systematic pain that disappeared within two months of surgery. CONCLUSION: The authors reported an unusual case of osteomalacia induced by multiple phosphaturic mesenchymal tumors located in the hallux. Definition of tumors localization by systemic venous sampling led to successful treatment and cure this patient. The presence of osteochondral tissues in the intraosseous tumor might be developed from undifferentiated mesenchymal cells due to high level of FGF23 produced by phosphaturic mesenchymal tumors.
[Mh] Termos MeSH primário: Fatores de Crescimento de Fibroblastos/sangue
Neoplasias de Tecido Conjuntivo/diagnóstico
Neoplasias Primárias Múltiplas/diagnóstico
Síndromes Paraneoplásicas/diagnóstico
Neoplasias de Tecidos Moles/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Meios de Contraste/administração & dosagem
Fraturas Múltiplas/etiologia
Hálux
Seres Humanos
Hipofosfatemia/sangue
Hipofosfatemia/etiologia
Hipofosfatemia/patologia
Hipofosfatemia/cirurgia
Imagem por Ressonância Magnética/métodos
Masculino
Neoplasias de Tecido Conjuntivo/sangue
Neoplasias de Tecido Conjuntivo/patologia
Neoplasias de Tecido Conjuntivo/cirurgia
Dor/etiologia
Síndromes Paraneoplásicas/sangue
Síndromes Paraneoplásicas/patologia
Síndromes Paraneoplásicas/cirurgia
Fosfatos/sangue
Fosfatos/urina
Neoplasias de Tecidos Moles/complicações
Neoplasias de Tecidos Moles/patologia
Neoplasias de Tecidos Moles/cirurgia
Tendões/patologia
Vitamina D
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media); 0 (Phosphates); 0 (fibroblast growth factor 23); 1406-16-2 (Vitamin D); 62031-54-3 (Fibroblast Growth Factors)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170215
[St] Status:MEDLINE
[do] DOI:10.1186/s12891-017-1446-z


  8 / 730 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28181822
[Au] Autor:Singh D; Chopra A; Ravina M; Kongara S; Bhatia E; Kumar N; Gupta S; Yadav S; Dabadghao P; Yadav R; Dube V; Kumar U; Dixit M; Gambhir S
[Ad] Endereço:1 Department of Nuclear Medicine, SGPGIMS, Lucknow, India.
[Ti] Título:Oncogenic osteomalacia: role of Ga-68 DOTANOC PET/CT scan in identifying the culprit lesion and its management.
[So] Source:Br J Radiol;90(1072):20160811, 2017 Apr.
[Is] ISSN:1748-880X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to evaluate the role of Ga-DOTANOC positron emission tomography (PET)/CT scan in localization of culprit lesion for biopsy and required intervention [surgical excision/radiofrequency ablation (RFA)] in patients with long-standing oncogenic osteomalacia (OOM)/tumour-induced osteomalacia. METHODS: 17 patients (8 males and 9 females) underwent Ga-DOTANOC PET/CT scan. The patients referred with clinical and biochemical evidence of hypophosphatemia and raised fibroblast growth factor-23. Qualitative and semi-quantitative parameters were used to identify culprit lesions. RESULTS: Ga-DOTANOC PET/CT scan revealed 52 lesions in 17 patients, and 37/52 of these lesions were tracer avid. 26/37 lesions were non-specific focal tracer-avid skeletal lesions (fractures or degenerative changes). 11/37 tracer-avid skeletal lesions present in 9 patients (3 lesions in 1 patient and 1 each in rest of the 8 patients) were highly suspicious for culprit lesions in view of high maximum standardized uptake value (SUV ) (range 1.5-15.4; mean 7.0 ± 4.6), lesion size (0.9-5.0 cm; mean 3.3 ± 1.5) and associated soft-tissue component. During subsequent imaging with CT/MRI, 7/9 patients showed concordant lesions which were excised or biopsied and histopathologically verified as phosphaturic mesenchymal tumours. Surgical excision was resorted to in most of the detected lesions, and RFA was performed in one patient. CONCLUSION: There is some overlap in SUV between fracture-/bone-associated lesions and culprit lesions with a tendency of most non-culprit lesions to have lower SUV and no associated soft-tissue component. In such scenario, intensely tracer-avid, larger non-fracture lesions with soft-tissue component may lead to identification of culprit lesion among multiple lesions. Following detection of culprit lesion, surgical removal is the best treatment. RFA is alternative to surgery in cases where surgery is not possible owing to osteopenia/poor bone health. Advances in knowledge: The main challenge in patients of long-standing OOM is the presence of multiple skeletal lesions (both tumour- or tracer-avid fractures), and it is confusing to identify culprit lesion. This was noted in our study with Ga-DOTANOC and has not been mentioned in studies performed with Ga-DOTATATE/TOC PET/CT. In such scenario, Ga-DOTANOC PET/CT needs to be reviewed and read thoroughly to localize the culprit lesion out of the multiple tracer-avid lesions.
[Mh] Termos MeSH primário: Neoplasias de Tecido Conjuntivo/diagnóstico por imagem
Neoplasias de Tecido Conjuntivo/terapia
Compostos Organometálicos
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Gerenciamento Clínico
Feminino
Seres Humanos
Masculino
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (68Ga-DOTANOC); 0 (Organometallic Compounds)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170924
[Lr] Data última revisão:
170924
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170210
[St] Status:MEDLINE
[do] DOI:10.1259/bjr.20160811


  9 / 730 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28119439
[Au] Autor:Sandoval MA; Palermo MA; Carrillo R; Bundoc R; Carnate JM; Galsim RJ
[Ad] Endereço:Department of Physiology, College of Medicine, University of the Philippines Manila, Manila, Philippines.
[Ti] Título:Successful treatment of tumour-induced osteomalacia after resection of an oral peripheral ossifying fibroma.
[So] Source:BMJ Case Rep;2017, 2017 Jan 24.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Tumour-induced osteomalacia is a paraneoplastic syndrome wherein bone is affected by a hormone from a tumour that causes renal phosphate wasting and hypophosphataemia. Here, we present the case of a 31-year-old man who has been suffering from generalised bone pains and a spine deformity that led to loss of height. Pertinent findings are low serum phosphorus, low vitamin D and decreased bone mineral density. These findings led to a diagnosis of osteomalacia. However, the finding of an oral mass raised some questions as to what role it plays in the patient's disease. It was suspected that the oral mass (fibroma) was producing a hormone that led to renal phosphate wasting, hypophosphataemia and then osteomalacia. This hypothesis was proven after surgical removal of the mass led to normalisation of the metabolic derangements and eventually led to a resolution of the bone pains.
[Mh] Termos MeSH primário: Fibroma Ossificante/complicações
Cifose/etiologia
Neoplasias Mandibulares/complicações
Neoplasias de Tecido Conjuntivo/etiologia
[Mh] Termos MeSH secundário: Absorciometria de Fóton
Adulto
Progressão da Doença
Fibroma Ossificante/patologia
Fibroma Ossificante/cirurgia
Seres Humanos
Úmero/diagnóstico por imagem
Cifose/diagnóstico por imagem
Imagem por Ressonância Magnética
Masculino
Neoplasias Mandibulares/patologia
Neoplasias Mandibulares/cirurgia
Ossos Metacarpais/diagnóstico por imagem
Ossos do Metatarso/diagnóstico por imagem
Neoplasias de Tecido Conjuntivo/diagnóstico por imagem
Radiografia
Ulna/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170309
[Lr] Data última revisão:
170309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE


  10 / 730 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27659744
[Au] Autor:Chazal T; Khanine V; Lidove O; Godot S; Ziza JM
[Ad] Endereço:Service de médecine interne et rhumatologie, groupe hospitalier diaconesses Croix-Saint-Simon, 125, rue d'Avron, 75020 Paris, France. Electronic address: thibchazal@gmail.com.
[Ti] Título:[Tumor-induced osteomalacia caused by a late-revealing phosphaturic mesenchymal tumor].
[Ti] Título:Ostéomalacie secondaire à une tumeur mésenchymateuse phosphaturique de révélation tardive..
[So] Source:Rev Med Interne;38(6):412-415, 2017 Jun.
[Is] ISSN:1768-3122
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:INTRODUCTION: Osteomalacia is associated with diffuse pain and multiple fractures and therefore, diagnosis and treatment of this condition are necessary. Clinicians should be aware of an uncommon mechanism of osteomalacia where hypophosphataemia is secondary to renal phosphaturia because of the production by a mesenchymal phosphaturic tumor of FGF-23. This tumor should be localized and removed to cure this tumor-induced osteomalacia. OBSERVATION: A 70-year-old female patient was admitted to explore diffuse pain caused by multiple fractures secondary to osteomalacia. Despite vitamin D supplementation, she remained profoundly hypophosphoremic with major renal phosphaturia. A tumor-induced mechanism was suspected because of high level of FGF-23. It took more than three years of investigation to spot the causal phosphaturic mesenchymal tumor despite annual repetition of indium-labelled scintigraphy and PET-scan. The resection of the tumor, located between two phalanges of the right foot, cured the patient with sustained normal rate of serum level of phosphorus after two years. CONCLUSION: Tumor-induced osteomalacia is a diagnostic challenge because the localization of the tumor may be a long process. Patients should be monitored clinically and imaging studies repeated until a diagnosis is made and the causal tumor removed.
[Mh] Termos MeSH primário: Hipofosfatemia Familiar/etiologia
Mesenquimoma/complicações
Neoplasias de Tecido Conjuntivo/etiologia
Neoplasias de Tecidos Moles/complicações
[Mh] Termos MeSH secundário: Idoso
Diagnóstico Tardio
Feminino

Seres Humanos
Hipofosfatemia/complicações
Hipofosfatemia Familiar/diagnóstico
Mesenquimoma/diagnóstico
Neoplasias de Tecido Conjuntivo/diagnóstico
Neoplasias de Tecidos Moles/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160924
[St] Status:MEDLINE



página 1 de 73 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde