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Recurrent phosphaturic mesenchymal tumour of the temporal bone causing deafness and facial nerve palsy

Published online by Cambridge University Press:  29 May 2012

M I Syed*
Affiliation:
Department of Otolaryngology, The Royal Infirmary, Edinburgh, Scotland, UK
M Chatzimichalis
Affiliation:
Department of Otolaryngology, University Hospital Zurich, Switzerland
M Rössle
Affiliation:
Institute of Clinical Pathology, University Hospital Zurich, Switzerland
A M Huber
Affiliation:
Department of Otolaryngology, University Hospital Zurich, Switzerland
*
Address for correspondence: Mr M I Syed, Department of Otolaryngology, The Royal Infirmary, Edinburgh E16 4SA, Scotland, UK Fax: +44 (0)131 536 3757 E-mail: [email protected]

Abstract

Objective:

We describe the first reported case of a phosphaturic mesenchymal tumour, mixed connective tissue variant, invading the temporal bone.

Case report:

A female patient presented with increasing deafness. On examination there appeared to be a mass behind an intact tympanic membrane. Further radiological investigation showed a vascular mass occupying the middle ear, mastoid and internal auditory meatus. This was surgically resected and revealed to be a benign phosphaturic mesenchymal tumour, mixed connective tissue variant. The tumour recurred a year later, presenting as facial nerve palsy. A revision procedure was carried out; the tumour was excised with the sacrifice of a segment of the facial nerve, and a facial-hypoglossal nerve anastomosis was performed.

Conclusion:

This case report highlights the occurrence of this benign but sometimes aggressive tumour, of which both clinicians and pathologists should be aware. Early recognition of the condition remains of utmost importance to minimise the debilitating consequences of long-term osteomalacia in affected patients, and to prevent extracranial and intracranial complications caused by the tumour.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

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References

1Weidner, N, Santa Cruz, D. Phosphaturic mesenchymal tumors. A polymorphous group causing osteomalacia or rickets. Cancer 1987;59:1442–543.0.CO;2-Q>CrossRefGoogle Scholar
2Folpe, AL, Fanburg-Smith, JC, Billings, SD, Bisceglia, M, Bertoni, F, Cho, JY et al. Most osteomalacia-associated mesenchymal tumors are a single histopathologic entity: an analysis of 32 cases and a comprehensive review of the literature. Am J Surg Pathol 2004;28:130CrossRefGoogle Scholar
3Shimada, T, Mizutani, S, Muto, T, Yoneya, T, Hino, R, Takeda, S et al. Cloning and characterization of FGF23 as a causative factor of tumor-induced osteomalacia. Proc Natl Acad Sci U S A 2001;98:6500–5CrossRefGoogle ScholarPubMed
4Jonsson, KB, Mannstadt, M, Miyauchi, A, Yang, IM, Stein, G, Ljunggren, O et al. Extracts from tumors causing oncogenic osteomalacia inhibit phosphate uptake in opossum kidney cells. J Endocrinol 2001;169:613–20CrossRefGoogle ScholarPubMed
5Shimada, T, Hasegawa, H, Yamazaki, Y, Muto, T, Hino, R, Takeuchi, Y et al. FGF-23 is a potent regulator of vitamin D metabolism and phosphate homeostasis. J Bone Miner Res 2004;19:429–35CrossRefGoogle ScholarPubMed
6Woo, VL, Landesberg, R, Imel, EA, Singer, SR, Folpe, AL, Econs, MJ et al. Phosphaturic mesenchymal tumor, mixed connective tissue variant, of the mandible: report of a case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:925–32CrossRefGoogle Scholar
7Reyes-Múgica, M, Arnsmeier, SL, Backeljauw, PF, Persing, J, Ellis, B, Carpenter, TO. Phosphaturic mesenchymal tumor-induced rickets. Pediatr Dev Pathol 2000;3:61–9CrossRefGoogle ScholarPubMed
8Uramoto, N, Furukawa, M, Yoshizaki, T. Malignant phosphaturic mesenchymal tumor, mixed connective tissue variant of the tongue. Auris Nasus Larynx 2009;36:104–5CrossRefGoogle ScholarPubMed