Successful Localization Using 68Ga-DOTATOC PET/CT of a Phosphaturic Mesenchymal Tumor Causing Osteomalacia in a Patient with Concurrent Follicular Lymphoma.
Sejin HaSujin ParkHyunji KimHeounjeong GoSeung Hun LeeJi Yoon ChoiJung Yong HongJin-Sook RyuPublished in: Nuclear medicine and molecular imaging (2018)
Diagnosing tumor-induced osteomalacia is often challenging because conventional imaging modalities may fail to locate the responsible tumor. This report describes the ability of 68Ga-DOTATOC PET/CT to successfully distinguish between the responsible phosphaturic mesenchymal tumor and concurrent lymphoma lesions. A 52-year-old man with bone pain for several years was diagnosed with a vitamin D-resistant hypophosphatemic osteomalacia. Whole body 18F-FDG PET/CT revealed multiple enlarged hypermetabolic lymph nodes in his bilateral cervical, axillary, mediastinal, abdominal, pelvic, and inguinal regions. Core needle biopsy of the right cervical lymph node confirmed the diagnosis of follicular lymphoma. However, lymphoma was not considered the cause of osteomalacia. 68Ga-DOTATOC PET/CT before chemotherapy showed a small nodule with intensely increased uptake in the right inguinal region, which was distinguished from the other enlarged lymph nodes. The nodule was surgically removed and histopathologically consistent with phosphaturic mesenchymal tumor. After surgery, the patient's serum phosphorus and alkaline phosphatase levels normalized without nutritional supplement.
Keyphrases
- pet ct
- lymph node
- positron emission tomography
- neoadjuvant chemotherapy
- bone marrow
- stem cells
- sentinel lymph node
- ultrasound guided
- case report
- locally advanced
- prostate cancer
- chronic pain
- high resolution
- diffuse large b cell lymphoma
- early stage
- rectal cancer
- pain management
- body composition
- computed tomography
- bone mineral density
- oxidative stress
- mass spectrometry
- photodynamic therapy
- high glucose
- single cell
- drug induced
- radical prostatectomy
- diabetic rats
- soft tissue