Abstract:
Objective To study the role of preoperative ultrasound in the targeted removal of soft-tissue tumor-associated hypophosphatemic osteomalacia, and to explore ultrasound features of benign and malignant lesions.
Methods We reviewed the sonographic and clinical records of 63 patients with soft-tissue tumor-induced hypophosphatemic osteomalacia who were treated at Peking Union Medical College Hospital between January 2005 and June 2016. Compared with surgical and pathological results, we retrospectively analyzed the ultrasonic features of benign and malignant lesions.
Results All 65 lesions in the 63 patients were removed completely and successfully as guided by preoperative localization with ultrasound.Pathology identified them all as phosphaturic mesenchymal tumors, including 56 benign lesions and 9 malignant lesions.The median maximum diameter of the benign group was 2.3(1.6-3.3)cm, and that of the malignant group was 3.0 (2.5-5.5)cm, there was no statistically significant difference between the two groups(P > 0.05). The malignant lesions were more likely to be of calcificacion and rich blood flow signals than benign lesions (100%/62.5%, 66.7%/28.57%, both P < 0.05). Other features such as shape, margin, border, structure, echogenicity and echo uniformity were found with no statistically significant difference(all P > 0.05). The ultrasound pattern was different between benign and malignant lesions (P=0.009), and 66.7% of the malignant lesions were in class Ⅰ, 33.3% were in class Ⅱ, while 80.3% of the benign lesions were in classes Ⅱ and Ⅲ.
Conclusions Ultrasonic preoperative localization could help guide complete resection of soft-tissue tumor-associated hypophosphatemic osteomalacia.Some specific ultrasound features and imaging patterns may be useful to differentiate malignant and benign lesions.