Humans ; Soft Tissue Neoplasms ; Mesenchymoma/diagnostic imaging* ; Paraneoplastic Syndromes/pathology*

Adult ; Aged ; Angiomyolipoma ; diagnosis ; diagnostic imaging ; Carcinoma, Renal Cell ; diagnosis ; diagnostic imaging ; Diagnosis, Differential ; Female ; Fibroma ; diagnosis ; diagnostic imaging ; Humans ; Kidney Neoplasms ; diagnosis ; diagnostic imaging ; Leiomyosarcoma ; diagnosis ; diagnostic imaging ; Male ; Mesenchymoma ; diagnosis ; diagnostic imaging ; Middle Aged ; Tomography, Spiral Computed ; methods

OBJECTIVETo observe the lower gastrointestinal mesenchymal tumors CT virtual endoscopy and pathology, and to explore its possible mechanism.

METHODSSelect 80 patients suspected colon gastroenterology treat in the hospital gastroenterology department, randomly divided into experimental group and control group, 40 cases in experimental group were given CT virtual endoscopy and pathological check, the control group received conventional colonoscopy and pathological check, and all the results compared with the pathological results.

RESULTSCompared with the pathological test results, consistent rate with the experimental group reached 94.73%, the same rate was 92.85% in control group. The difference was not statistically significant (P > 0.05).

CONCLUSIONSCT virtual endoscopy can quickly image and draw detailed information, and can improve the sensitivity and specificity of cancer diagnosis greatly. Clinically, CT virtual endoscopy have the same function as colonoscopy, can replace colonoscopy, can be important complement of electronic colonoscopy by those who cannot tolerate electronic colonoscopy or have contraindications. Its value is worth taking a step forward in-depth study.

Adult ; Aged ; Colonoscopy ; Colorectal Neoplasms ; diagnostic imaging ; pathology ; Endoscopy, Gastrointestinal ; methods ; Female ; Humans ; Male ; Mesenchymoma ; diagnostic imaging ; pathology ; Middle Aged ; Tomography, X-Ray Computed

Tumor-induced osteomalacia (TIO), or oncogenic osteomalacia (OOM), is a rare acquired paraneoplastic disease characterized by renal phosphate wasting and hypophosphatemia. Recent evidence shows that tumor-overexpressed fibroblast growth factor 23 (FGF23) is responsible for the hypophosphatemia and osteomalacia. The tumors associated with TIO are usually phosphaturic mesenchymal tumor mixed connective tissue variants (PMTMCT). Surgical removal of the responsible tumors is clinically essential for the treatment of TIO. However, identifying the responsible tumors is often difficult. Here, we report a case of a TIO patient with elevated serum FGF23 levels suffering from bone pain and hypophosphatemia for more than three years. A tumor was finally located in first metacarpal bone by octreotide scintigraphy and she was cured by surgery. After complete excision of the tumor, serum FGF23 levels rapidly decreased, dropping to 54.7% of the preoperative level one hour after surgery and eventually to a little below normal. The patient's serum phosphate level rapidly improved and returned to normal level in four days. Accordingly, her clinical symptoms were greatly improved within one month after surgery. There was no sign of tumor recurrence during an 18-month period of follow-up. According to pathology, the tumor was originally diagnosed as "lomangioma" based upon a biopsy sample, "proliferative giant cell tumor of tendon sheath" based upon sections of tumor, and finally diagnosed as PMTMCT by consultation one year after surgery. In conclusion, although an extremely rare disease, clinicians and pathologists should be aware of the existence of TIO and PMTMCT, respectively.
Bone Neoplasms ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Female ; Fibroblast Growth Factors ; blood ; Follow-Up Studies ; Humans ; Hypophosphatemia ; blood ; diagnostic imaging ; etiology ; pathology ; surgery ; Mesenchymoma ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Metacarpal Bones ; Middle Aged ; Neoplasms, Connective Tissue ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Osteomalacia ; blood ; diagnostic imaging ; etiology ; pathology ; surgery ; Phosphates ; blood ; Radiography

Actins ; metabolism ; Bone Neoplasms ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Hypophosphatemia ; blood ; etiology ; Ilium ; Mesenchymoma ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Middle Aged ; Osteomalacia ; blood ; etiology ; Phosphates ; blood ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Tomography, X-Ray Computed