BMJ Case Reports 2014; doi:10.1136/bcr-2013-202827

Mesenchymal phosphaturic tumour: early detection of recurrence

Editor's Choice
  1. Giacomo Colletti2
  1. 1Department of Maxillofacial Surgery, Università degli Studi di Milano, Milan, Italy
  2. 2Ospedale San Paolo, Milan, Italy
  3. 3Azienda Ospedaliera Universitaria Verona, Verona, Italy
  1. Correspondence to Dr Giacomo Colletti, giacomo.colletti{at}
  • Accepted 4 April 2014
  • Published 14 May 2014


The case of a recurrent phosphaturic mesenchymal tumour of the maxillary sinus 10 years after the first surgical excision is reported. The neoplasm first presented with paraneoplastic osteomalacia causing a pathological femur fracture. A right maxillary sinus tumour was identified and treated thereafter. The patient had no local symptoms and serum electrolytes returned to normal after surgical removal of the tumour. However, 10 years later, the patient's urine Ca and P levels increased and an octreoscan detected a new tumour in the right maxillary sinus. Early diagnosis prevented the effects of the paraneoplastic activity of the neoplasm. This case emphasises the importance of specific, close follow-up, because the neoplasm rarely produces local signs indicating its position. To our knowledge, this is the first reported case of a late relapse presenting without relevant symptoms (local pain or swelling or pathological fractures).

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