Whole-body (99m)Tc-octreotide scintigraphy with SPECT/CT to detect occult tumor inducing paraneoplastic osteomalacia.
A 32-year-old woman presented with progressive myalgia, bone pain, fatigue, insufficiency hip fractures, high urine phosphate, and low serum phosphate and vitamin D levels. These findings were suggestive of oncogenic osteomalacia. A whole-body Tc-octreotide scintigraphy with SPECT/CT showed uptake on a sclerotic intramedullary lesion in the left medial tibia plateau. MRI depicted a solid lesion. The lesion was surgically removed; the patient became asymptomatic, and follow-up laboratory results normalized. Histopathologic examination revealed a vascular hemangiopericytoma-like tumor, positive for somatostatin receptor (SSR-2). Whole-body Tc-octreotide scintigraphy with SPECT/CT may detect occult oncogenic osteomalacia tumors.
From the Divisions of *Nuclear Medicine, and †Rheumatology of the Sirio-Libanes Hospital, São Paulo; Departments of ‡Orthopedic Surgery, and §Pathology, Campinas University, Brazil.
Napoleão Ramalho
NR
Rodrigues
Ana Luisa
AL
Calich
Mauricio
M
Etchebehere
Wilson Andre
WA
Ichiki
Fabio Payao
FP
Pereira
Elaine Maria Ingrid
EM
Amstalden
Elba Cristina
EC
de Sa Etchebehere
D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D064847:Multimodal Imaging; D009372:Neoplasms, Connective Tissue / Q000000981:diagnostic imaging* / Q000556:secondary; D009382:Neoplasms, Unknown Primary / Q000000981:diagnostic imaging*; D015282:Octreotide / Q000031:analogs & derivatives*; D015609:Organotechnetium Compounds; D010018:Osteomalacia; D010257:Paraneoplastic Syndromes; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
C493098:99mTc-octreotide; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D015282:Octreotide