PMC3533608_01
MRI lumbar spine: enhanced T1 weighted axial image. Enhancing, well-defined benign phosphaturic mesenchymal tumor in lumbar vertebra.
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fig1
An outside MRI of the lumbar spine showed an infiltrative lesion in the L-4 vertebra with collapse of the body (confirmed on repeat MRI at our institution, Figure 1).
Coronal PET-CT scan. Hypermetabolic focus corresponding to the lumbar lesion.
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fig2
The L-4 lesion was hypermetabolic on PET scan (Figure 2).
Photomicrograph (H&E stain, 10x; inset lower left, 60x) showing uniform bland appearing spindle cells with hemangiopericytoma-like vasculature. Rare multinucleate giant cells (not pictured) were also present.
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fig3
A repeat CT guided needle biopsy of L-4 showed a low grade spindle cell neoplasm with positive FGF-23 mRNA expression by RT-PCR (Figure 3), confirming the diagnosis of mixed phosphaturic mesenchymal tumor (PMT).