Presenter
Karina C. Martin
Authors
Karina C. Martin1, Stephen Yip1, Ian Mackenzie1
1-Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Conflict of Interest
I do not have a relationship with a for-profit and/or a not-for-profit organization to disclose.
Clinical Summary
A 49-year-old female, with a history of iron deficiency anemia and GERD, was investigated for longstanding low back pain. MRI of the lumbar spine and sacrum revealed hyperintense lesions with surrounding bone marrow edema in the bilateral sacral ala, iliac wings, acetabuli, and right femoral neck. Extensive imaging studies were undertaken to further characterize these lesions. A 3.2 x 2.8 x 3.3 cm heterogeneously enhancing right frontal dural-based mass that was 68Ga-DOTATOC avid was identified. Neurosurgery was consulted and a right frontal craniotomy and resection of tumor was performed. Intra-operative findings showed a significantly vascular right frontal dural-based tumor.
Discussion points
- What is the differential diagnosis and which immunohistochemical stains would aid in narrowing the differential?
- Which additional molecular tests would help confirm the diagnosis?
Reveal Diagnosis
Phosphaturic mesenchymal tumor
Additional relevant investigations and comment.
FGF23 CISH – positive
FN1-FGFR1 fusion analysis
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