Delineation of the phenotypes and genotypes of PIK3CA-related overgrowth spectrum in East asians.

PIK3CA-related overgrowth spectrum (PROS) is an umbrella term to describe a diverse range of developmental disorders. Research to date has predominantly emerged from Europe and North America, resulting in a notable scarcity of studies focusing on East Asian populations. Currently, the prevalence and distribution of PIK3CA variants across various genetic loci and their correlation with distinct phenotypes in East Asian populations remain unclear. This study aims to elucidate the phenotype-genotype correlations of PROS in East Asian populations. We presented the phenotypes and genotypes of 82 Chinese patients. Among our cohort, 67 individuals carried PIK3CA variants, including missense, frameshift, and splice variants. Six patients presented with both PIK3CA and an additional variant. Seven PIK3CA-negative patients exhibited overlapping PROS manifestations with variants in GNAQ, AKT1, PTEN, MAP3K3, GNA11, or KRAS. An integrative review of the literature pertaining to East Asian populations revealed that specific variants are uniquely associated with certain PROS phenotypes. Some rare variants were exclusively identified in cases of megalencephaly and diffuse capillary malformation with overgrowth. Non-hotspot variants with undefined oncogenicity were more common in CNS phenotypes. Diseases with vascular malformation were more likely to have variants in the helical domain, whereas phenotypes involving adipose/muscle overgrowth without vascular abnormalities predominantly presented variants in the C2 domain. Our findings underscore the unique phenotype-genotype patterns within the East Asian PROS population, highlighting the necessity for an expanded cohort to further elucidate these correlations. Such endeavors would significantly facilitate the development of PI3Kα selective inhibitors tailored for the East Asian population in the future.

Advancements in understanding bacterial enteritis pathogenesis through organoids.

Bacterial enteritis has a substantial role in contributing to a large portion of the global disease burden and serves as a major cause of newborn mortality. Despite advancements gained from current animal and cell models in improving our understanding of pathogens, their widespread application is hindered by apparent drawbacks. Therefore, more precise models are imperatively required to develop more accurate studies on host-pathogen interactions and drug discovery. Since the emergence of intestinal organoids, massive studies utilizing organoids have been conducted to study the pathogenesis of bacterial enteritis, revealing new mechanisms and validating established ones. In this review, we focus on the advancements of several bacterial pathogenesis mechanisms observed in intestinal organoid/enteroid models, exploring the host response and bacterial effectors during the infection process. Finally, we address the features that warrant additional investigation or could be enhanced in existing organoid models in order to guide future research endeavors.

Effects of family function, depression, and self-perceived burden on loneliness in patients with type 2 diabetes mellitus: a serial multiple mediation model.

BACKGROUND: Type 2 Diabetes mellitus (T2DM) has become a major lifestyle disease endangering human health worldwide. Patients with T2DM face varying degrees of loneliness, which adversely affects their family and the larger society. This study investigates the serial multiple mediating roles of depression and self-perceived burden between family function and loneliness in the T2DM population of China. METHODS: In total, 260 T2DM patients were included. They rated themselves based on UCLA Loneliness Scale, Self-Rating Depression Scale, Self-Rating Anxiety Scale, Family Care Index, and Self-Perceived Burden Scale. Pearson and Spearman correlation analyses were conducted to clarify the association among variables. The SPSS macro-PROCESS program was used for a series of multiple mediation analyses. RESULTS: Family function, depression, self-perceived burden, and loneliness were significantly correlated (P < 0.01). Family function not only has a direct negative impact (effect = -2.809; SE = 0.213; 95%CI: LL = -3.228, UL = -2.390) on loneliness, but also has an indirect impact on loneliness through the independent mediating role of depression (effect = -0.862; SE = 0.165; 95%CI: LL = -1.202, UL = -0.567) and self-perceived burden (effect = -0.288; SE = 0.107; 95%CI: LL = -0.525, UL = -0.114) and the chain mediating role of depression and self-perceived burden (effect = -0.202; SE = 0.066; 95%CI: LL = -0.342, UL = -0.088). CONCLUSIONS: Diversified interventions aimed at improving family function of T2DM patients would help in reducing the level of depression and self-perceived burden, and ultimately reducing loneliness.

Improving distance imaging accuracy through temporal position correction with phase difference compensation.

This study introduces a time-domain-based phase compensation method to address decoherence effects in optical heterodyne detection, which is critical for remote sensing and distance imaging. The numerical simulations demonstrate a substantial reduction in localization bias (6.56-2.85) and an increased probability of bias values below 2 (21.6%-70.5%). The experiments show significant improvement in whiteboard distance imaging accuracy at 10 m from the detector, with 91.7% of the data falling within 10-12 m, compared to a mere 2.3% accuracy before compensation. The method effectively enhances intensity image quality, mitigates decoherence phenomena, and improves detection accuracy and reliability without additional hardware.

The application of a hollow trephine in femoral retrograde intramedullary nailing technique.

PURPOSE: The purpose of this study was to describe and evaluate the use of a specially designed hollow trephine to create the entry point through the femoral condyle during retrograde interlocking intramedullary nailing for femoral fractures. METHODS: From June 2019 to December 2021, we treated 11 patients (5 men, 6 women; mean age, 64 years; age range 40-77 years) with mid-distal femoral fractures by retrograde intramedullary femoral nailing using a self-designed hollow trephine for femoral condyle reaming and cancellous bone harvesting. The mode of all the nails is static. Patients were followed up at 1, 4, 8, and 12 weeks and for at least 6 months after surgery. The healing process and heterotopic ossification were evaluated by imaging. Partial weight bearing was permitted during the recovery period and complete weight bearing was permitted after clinical healing of the fracture displayed by X-ray. RESULTS: The operation was successful in all patients. Over mean follow-up of 9.3 months (range, 6.0-12.0 months), all patients achieved clinical healing within three months. There were no complications such as knee joint infection, heterotopic ossification, knee joint adhesion and wedge effect. CONCLUSION: The use of the hollow trephine during femoral retrograde intramedullary nailing helps avoid postoperative complications such as heterotopic ossification, knee joint adhesions, and wedge effect. It also facilitates bone graft harvesting.

NCX2 Regulates Intracellular Calcium Homeostasis and Translocation of HIF-1α into the Nucleus to Inhibit Glioma Invasion.

Glioma is the most common tumor of the central nervous system, and its poor prognosis can be linked to hypoxia and gene inactivation. Na+/Ca2+ exchanger 2 (NCX2) is expressed only in the normal brain and not in other tissues or glioma. We constructed a hypoxic microenvironment to more accurately understand the effect of NCX2 in glioma. Our previous experiments confirmed that NCX2 inhibited the growth of U87 cells in nude mice, indicating that NCX2 is a potential tumor suppressor gene. Malignant tumor cells are often exposed to an anoxic environment. To more accurately understand the effect of NCX2 in glioma, we constructed a hypoxic microenvironment. To detect the localization of NCX2 in transfected U87 cells, immunofluorescence was used. We tested the function of NCX2 in glioma, i.e., how it contributes to the cytosolic Ca2+ homeostasis by X-Rhod-1. We tested the cell proliferation of NCX2 in glioma in hypoxic using Cell counting kit-8 (CCK8). Cell migration and invasion were evaluated in 24-well transwell matrigel-coated or non-matrigel-coated in hypoxia. NCX2 promoted the proliferation of U87 cells in the hypoxic microenvironment. It inhibited the invasion and migration abilities of U87 cells. We demonstrated that NCX2 was located on the cell membrane and that it reduced intracellular Ca2+ levels and reactivated P53 and PTEN. We further demonstrated that NCX2 impaired cell invasion through the HIF-1α pathway in glioma. The results indicated that NCX2 plays a key role in glioma formation and tumor invasion functionality.

Updates on Diagnosis and Treatment of PIK3CA-Related Overgrowth Spectrum.

ABSTRACT: Hyperactivation of the PI3K/AKT/mTOR signaling pathway caused by PIK3CA mutations is associated with a category of overgrowth syndromes that are defined as PIK3CA -related overgrowth spectrum (PROS). The clinical features of PROS are highly heterogeneous and usually present as vascular malformations, bone and soft tissue overgrowth, and neurological and visceral abnormalities. Detection of PIK3CA variants is necessary for diagnosis and provides the basis for targeted therapy for PROS. Drugs that inhibit the PI3K pathway offer alternatives to conventional therapies. This article reviews the current knowledge of PROS and summarizes the latest progress in precise treatment, providing new insights into future therapies and research goals.

The impact of distance education on nursing students course performance in a sino-foreign cooperative program during the onset of COVID-19: a quasi-experimental study.

BACKGROUND: The outbreak of COVID-19 changed many studies' teaching mode in higher education profoundly, including nursing. This study evaluated the impact of distance education on the course performance of nursing students in a nursing fundamentals course during the epidemic of COVID-19. METHODS: This is a comparative prospective and retrospective quasi-experimental study. Nursing students in a Sino-foreign cooperative program were allocated to either an intervention group (distance education, n = 48) or control group (face-to-face teaching, n = 36). A self-efficacy questionnaire, an academic engagement scale and grades of the final written examination were used to evaluate the students' self-efficacy, academic engagement and academic performance, respectively. The data in this study were analyzed by two independent sample t-tests and the Chi-square test. Students experiencing distance teaching had worse academic performance (p = 0.001) and lower levels of learning behavior self-efficacy (p<0.05). The total score of academic engagement (p = 0.04) for students experiencing distance teaching were significantly lower than the scores of those students in the control group. CONCLUSIONS: In the context of COVID-19, nursing students conducted using distance education had poor course performance.

Comparison of magnetic susceptibility probes relevantly used in soil contamination applications.

Magnetic susceptibility (MS) technology can achieve the efficient rough measurement, mapping, and pollution assessment of soil heavy metal concentrations in topsoil due to atmospheric dust contamination. However, previous studies of commonly used MS field probes (MS2D, MS2F, and MS2K) have not dealt with the range of magnetic signal detection and the attenuation characteristics of the signal with respect to distance. In this study, the vertical and horizontal measurement ranges of the MS2D, MS2F, and MS2K probes were explored through laboratory and field experiments, and the intensity of their magnetic signals was further compared and analyzed in the field. The results showed that the magnetic signal intensity of the three probes decreased exponentially with distance. The penetration depths of the MS2D, MS2F, and MS2K probes were 8.5, 2.4, and 3.0 cm, respectively, and the horizontal detection boundary lengths of their magnetic signals were 32, 8, and 6.8 cm, respectively. In the field surface soil MS detection, the magnetic measurement signals of the MS2F and MS2K probes showed a weak linear correlation with the MS2D probe (R2 of 0.43 and 0.50, respectively), while the MS2F and MS2K probes had a significantly better correlation (R2 = 0.68) with each other. In general, the MS2D probe and MS2K probe correlation had a slope close to unity, meaning MS2K probes had good mutual substitution. Furthermore, results of this study improve the effectiveness of the MS evaluation of heavy metal pollution in urban topsoil.

Dual-strategy biosensing of glucose based on multifunctional CuWO4 nanoparticles.

In this research, dual-strategy biosensing of glucose was proposed based on multifunctional CuWO4 nanoparticles (CuWO4 NPs), which were prepared for the application of electrochemical and colorimetric sensing of glucose. CuWO4 NPs show large specific surface area and good conductivity as well as excellent peroxidase-like activity. A sensitive and selective electrochemical glucose biosensor was fabricated with the immobilization of glucose oxidase (GOx) on a CuWO4 NP modified electrode for enhancing the direct electron transfer behavior. A wide linear range of 0.005-1.8 mM with a low detection limit of 1.5 µM and a high sensitivity of 28.02 mA M-1 cm-2 were achieved by using the electrochemical biosensor. Meanwhile, a colorimetric and visual glucose biosensor was constructed based on the GOx/CuWO4 cascade nanozyme, which shows a linear range of 0.05-1.0 mM with excellent selectivity. CuWO4 NPs as a promising matrix open up a dual-strategy biosensor for sensitive and selective detection of glucose.

Prevalence and Influencing Factors of Irritable Bowel Syndrome in Medical Staff: A Meta-Analysis.

BACKGROUND: Irritable bowel syndrome (IBS) is a common functional digestive tract disease worldwide, with a high prevalence among medical staff. The purpose of this study is to systematically evaluate the prevalence and influencing factors of IBS in medical staff. METHODS: We searched English online databases, including PubMed, The Cochrane Library, Web of Science, Embase, and EBSCOhost. The retrieval time was from database establishment to May of 2021. We screened the literature according to inclusion and exclusion criteria, extracted the relevant information, and evaluated the research quality. A meta-analysis was performed using the Stata 16.0 and Review Manager 5.4.1 software. RESULTS: A total of 11 English studies from seven countries were included in this study, including 3,360 medical staff. The results of the meta-analysis showed an overall prevalence of IBS among medical staff of 16% [95%CI (0.15 ~ 0.17)] and that shift work (OR 2.27)), poor sleep quality (OR 4.27), and female gender (OR 2.29) are the major influencing factors of medical staff suffering from IBS. CONCLUSIONS: The prevalence of irritable bowel syndrome among medical staff is relatively high, and hospitals can start by looking for targeted interventions from the highly related factors of IBS among medical staff such as shift work patterns, females, and poor sleep quality.

Fulminant Guillain-Barré syndrome developed after surgical treatment of intracranial hemorrhage due to arteriovenous malformation: a case report.

Guillain-Barré syndrome (GBS) is a rare autoimmune disorder. GBS after surgical treatment of intracranial hemorrhage due to arteriovenous malformation (AVM) is even rarer. We present a 62-year-old man diagnosed with intracranial AVM and cerebral hemorrhage. He developed GBS after the operation for AVM and cerebral hemorrhage. Following surgical excision of AVM and cerebral hematoma, the patient developed generalized weakness, with subsequent quadriplegia and life-threatening dyspnea. The diagnosis was confirmed to be the acute motor-sensory axonal neuropathy subtype of GBS after cerebrospinal fluid analysis and antibody tests. The patient responded poorly to immunoglobulin and steroid therapy. His family abandoned further management and signed out of the hospital against medical advice. Despite being rare, GBS can occur after intracranial hemorrhage and surgery. Clinicians should rule out GBS when patients show no improvement or develop new neurologic.

A cleanup method of serum extracts with molecular sieves as SPE sorbents for the analysis of polybrominated diphenyl ethers.

Based on the size- and shape-selective sorption, 13X molecular sieves were developed as solid-phase extraction adsorbents to cleanup serum extract for the determination of polybrominated diphenyl ethers. The important parameters affecting the cleanup efficiency were investigated including the amount of sorbents, the type, and volume of solvents. Under the optimized conditions, the capacity for removing impurities was evaluated via gel permeation chromatography and gas chromatography with mass spectrometry. The results demonstrated that up to 99% of lipids in corn oil (13 mg) can be removed after cleanup, and endogenous compounds in serum can also be effectively eliminated. The cleanup efficiency is not only superior to hydrophile-lipophile balance column, but also close to acid silica gel and multifunction impurity sorbents. Generally, the developed cleanup method exhibited higher recovery for polybrominated diphenyl ethers with more than four bromines, especially for nona- and deca-brominated diphenyl ethers (99.1-117.8%). The cleanup method can be coupled with gas chromatography and tandem mass spectrometry for polybrominated diphenyl ethers analysis in human serum. The method detection limits were 0.01-0.27 ng/mL and average recovery was 50.9-113.3%, except 2,3',4',6-tetrabrominated, 2,3',4,4',6-pentabrominated, and 2,3,3',4,4',5',6-heptabrominated diphenyl ethers. 2,2',4,5'-Tetrabrominated diphenyl ethers had the highest detection frequency (95%) in human serum, whereas decabrominated diphenyl ethers had the maximum mean concentration (0.50 ng/mL).

Vertical distribution of antibiotics and antibiotic resistance genes in a representative municipal solid waste landfill, China.

The vertical distribution of sulfonamides (SAs), tetracyclines (TCs), macrolides (MLs), and their related antibiotic resistance genes (ARGs) were comprehensively investigated and characterized in a representative municipal solid waste (MSW) landfill in China. The total concentrations of target antibiotics in the MSW landfill were SAs > TCs > MLs. The abundances of mexF (10.78 ± 0.65 log10copies/g) and sul genes (9.15 ± 0.54 log10copies/g) were relatively high, while the tet genes (7.19 ± 0.77 log10copies/g) were the lowest. Both the abundance of antibiotics and genes fluctuated with landfill depth, and the ARGs of the same antibiotics were consistent with depth change. Intl1 and sul genes (sul1, sul2) were tightly connected, and a close relationship also existed between tet genes (tetM, tetQ) and MLs resistance genes (ermB, mefA). High-throughput sequencing showed the dominant genera were Sporosarcina (38%) and Thiobacillus (17%) at sampling points A and C, while the microbial community varied with depth increase at point B were Brevundimonas (20%), Sporosarcina (20%), Pseudomonas (24%), Lysobacter (28%), and Thioalkalimicrobium (14%), respectively. Network analysis further visualized the relationship among antibiotics, genes, and microbial communities and the results indicated the non-random connection among them and the possible host of the target gene. Even at 12.0 m below the landfill surface, the pollution of antibiotics resistance was still serious, which posed difficulties for subsequent landfill remediation and pollution control.

Related factors associated with fear of hypoglycemia in parents of children and adolescents with type 1 diabetes - A systematic review.

PROBLEM: Fear of hypoglycemia is a significant concern for parents of children/ adolescents with type 1 diabetes. Although some studies have explained the parental fear of hypoglycemia, the related factors were yet to be determined. This systematic review aims to identify the related factors of fear of hypoglycemia in the parents of children and adolescents with type 1 diabetes and provide a theoretical basis for further intervention. ELIGIBILITY CRITERIA: PubMed, MEDLINE, EMBASE, Scopus, CINAHL, EBSCO, Web of Science, and Cochrane Library were systematically searched from 2010 to 2021. Studies evaluating the fear of hypoglycemia of parents and its associated factors were included. SAMPLE: Twenty-three observational articles met the criteria. RESULTS: Significant associations were found between fear of hypoglycemia and specific factors, including motherhood, nocturnal hypoglycemia, and the number of blood glucose monitoring. Psychological factors, including anxiety, depression, pediatric parenting stress, mindfulness, self-efficacy, quality of life, and sleep disorders, were conclusive and associations with parental fear of hypoglycemia. CONCLUSIONS: Understanding parental fear of hypoglycemia can help parents prevent potential problems in diabetes management, thus promoting children's growth. According to current evidence, effective targeted interventions based on modifiable relevant factors can be developed to reduce the fear of hypoglycemia in parents while maintaining optimal blood glucose control in children/ adolescents. IMPLICATIONS: Health professionals should pay more attention to the mental health of parents, and parents should be involved in the care plan and have the opportunity to discuss their fear of hypoglycemia in the most appropriate way to manage type 1 diabetes.

Classification and morphology of hyperextension tibial plateau fracture.

PURPOSE: This study was aimed at analyzing the incidence and characteristics of hyperextension tibial plateau fractures (HTPFs) by using a computed tomography (CT)-based "four-column and nine-segment" classification. METHODS: In the coronal plane, HTPFs are divided into four types: pure hyperextension, hyperextension-varus, hyperextension-valgus, and hyperextension-bicondylar. Fractures in the sagittal plane were divided into three types: type 1, pure depression; type 2, cleavage extending to the posterior cortex with no displacement; and type 3, cleavage extending to the posterior cortex with a significant displacement. A retrospective analysis of CT images of the tibial plateau fractures from December 2007 to December 2021 was conducted. Fracture mapping was analyzed and drawn using the new classification system. RESULTS: A total of 136 (10.9%, 136/1253) fractures fulfilled the radiographic criteria for HTPF pattern in 136 knees (53.5 ± 13.3 years). There were 11 knees with pure hyperextension fracture (8.1%), 23 with hyperextension-varus fracture (16.9%), 46 with hyperextension-valgus fracture (33.8%), and 56 with hyperextension-bicondylar fracture (41.2%) in the coronal plane. Furthermore, there were 64 (47.1%), 47 (34.6%), and 25 (18.4%) cases of type 1, type 2, and type 3 fractures, respectively, in the sagittal plane. In the three-dimensional heat map, the fracture lines were mainly located at the anterior rim of the tibial plateau, while the posterior articular surface was rarely involved. CONCLUSIONS: The main manifestations of HTPF are anterior compression and posterior avulsion injury. The CT-based four-column and nine-segment classification system could be used to categorize the injury characteristics of HTPF in the coronal and sagittal planes.

Homoharringtonine inhibits the progression of hepatocellular carcinoma by suppressing the PI3K/AKT/GSK3ß/Slug signaling pathway.

Homoharringtonine (HHT), was first isolated from the bark of Cephalotaxus harringtonia (Knight ex J. Forbes) K. Koch and Cephalotaxus fortunei Hook trees. The bark extract is used to treat leukemia and in recent years has also been used in traditional Chinese medicine (TCM) to treat solid tumors. However, the inhibitory mechanism of HHT in the progression of hepatocellular carcinoma (HCC) is rarely studied. We aimed to evaluate the antitumor efficacy of HHT on HCC in vitro and in vivo and elucidate the underlying molecular mechanism(s). HCC cell lines, including HCCLM3, HepG2, and Huh7, were used to evaluate the antitumor efficacy of HHT in vitro. Cytotoxicity and proliferative ability were evaluated by MTT and colony formation assays. Cell cycle progression and apoptosis in HHT-treated HCC cells were evaluated by flow cytometry. To determine the migration and invasion abilities of HCC cells, wound-healing and Transwell assays were used. Finally, western blot analysis was used to reveal the proteins involved. We also established a xenograft nude mouse model for in vivo assessments of the preclinical efficacy of HHT, mainly using hematoxylin and eosin staining, immunohistochemistry, ultrasound imaging (USI), and magnetic resonance imaging (MRI). HHT suppressed the proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of HCC cells, and induced cell cycle arrest at the G2 phase and apoptosis. In the HCC xenograft model, HHT showed an obvious tumor-suppressive effect. Surprisingly, Slug expression was also decreased by HHT via the PI3K/AKT/GSK3ß signaling pathway at least partially suppressed the growth of HCC via the PI3K/AKT/GSK3ß/Slug signaling pathway.

Removal of Di-n-butyl phthalate from aged leachate under optimal hydraulic condition of leachate treatment process and in the presence of its dominant bacterial strains.

The effects of hydraulic condition of reactor and the dominant degrading bacteria on the removal of di-n-butyl phthalate (DBP) from aged landfill leachate by anaerobic/anoxic/oxic (A/A/O) leachate treatment process were investigated. The optimal DBP removal (96.0%) was obtained from aged leachate when the hydraulic retention time (HRT) of the reactor was 3 d, internal reflux ratio of the reactor was 200%, and external reflux ratio of the reactor was 60%, respectively. The removal efficiency of DBP was significantly improved after the inoculation of the dominant DBP-degrading bacteria (Pseudomonas sp. W1) in the reactor. The mean removal efficiencies of DBP before and after inoculation were 94.1% and 97.7%, respectively. Furthermore, the inoculation of dominant DBP-degrading bacteria changed the original sludge structure and characteristics, which was more conducive to the removal of DBP. These results provide theoretical basis for the effective removal of DBP from aged leachate by the biological treatment process.

Managing Vascular Anomalies in the Era of Genetics and Precision Medicine: An Opportunity or a Challenge?

ABSTRACT: The era of genetics and precision medicine has been reforming this world. How will plastic surgeons in the field of vascular anomalies conform to the trend? This article systematically reviews the identification of serum biomarkers, risk factors, specific mutations in the angiogenesis-related genes such as GNAQ, RASA1, TEK, and their impact on the diagnosis and treatment of vascular anomalies with preliminary results that have been previously reported and leading the tide. Moreover, a new disease classification for complex vascular malformations based on PIK3CA genetic evidence and various treatment breakthroughs is briefly summarized. With gene sequencing, bioinformatics, and big data, we confront the challenges of research in the vascular anomalies domain and explore possibilities of precision medicine development.

Tumor-Induced Osteomalacia Caused by a Phosphaturic Mesenchymal Tumor of the Sole Presenting as a Crippling Illness in a Postmenopausal Woman.

Tumor-induced osteomalacia, a rare and intriguing paraneoplastic syndrome that is usually caused by a phosphaturic mesenchymal tumor, leads to severe pain and hypophosphatemia. However, during clinical practice, most patients suffer from significant delay of diagnosis and treatment because the symptoms are similar to those of some very common diseases, such as osteoporosis and osteoarthritis. Moreover, physical complaints from postmenopausal women usually exacerbate the possibility of such delays. We describe a case of a postmenopausal woman with crippling bone pain and weakness, who had been diagnosed with a case of simple osteoporosis and osteoarthritis for 3 years, even with fine-needle aspiration biopsy of the offending phosphaturic mesenchymal tumor. After surgical removal of the 2 × 3-cm2 tumor in her sole, we observed immediate relief of her systemic symptoms, with visual analogue scale improvement from 5 of 10 preoperatively to 2 of 10 5 days after surgery. There were no signs of recurrence during 2-year follow-up. This case highlights the significance of thorough history-taking as a fundamental tool for diagnosis even in the era of advanced technology, and that the awareness of tumor-induced osteomalacia should be raised. Otherwise, such a small localized soft tissue mass would seldom be associated with the severe systemic symptoms.