Successful Localization Using ⁶⁸Ga-DOTATOC PET/CT of a Phosphaturic Mesenchymal Tumor Causing Osteomalacia in a Patient with Concurrent Follicular Lymphoma
10.1007/s13139-018-0546-5
- Author:
Sejin HA
1
;
Sujin PARK
;
Hyunji KIM
;
Heounjeong GO
;
Seung Hun LEE
;
Ji Yoon CHOI
;
Jung Yong HONG
;
Jin Sook RYU
Author Information
1. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea. jsryu2@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
PET/CT;
⁶⁸Ga-DOTATOC;
Hypophosphatemia;
Oncogenic osteomalacia;
Phosphaturic mesenchymal tumor
- MeSH:
Alkaline Phosphatase;
Biopsy, Large-Core Needle;
Diagnosis;
Drug Therapy;
Humans;
Hypophosphatemia;
Lymph Nodes;
Lymphoma;
Lymphoma, Follicular;
Middle Aged;
Osteomalacia;
Phosphorus;
Positron-Emission Tomography and Computed Tomography;
Vitamins
- From:Nuclear Medicine and Molecular Imaging
2018;52(6):462-467
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
