Bhalla Manav I, Wirtz Kennedy M, Fair Eric S, Bucklan Daniel J
Department of Radiology, Froedtert Hospital and The Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
World J Nucl Med. 2019 Jul 23;19(1):78-81. doi: 10.4103/wjnm.WJNM_92_18. eCollection 2020 Jan-Mar.
Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) has shown superiority over Indium-octreotide scanning for the detection of phosphaturic mesenchymal tumors (PMTs). We report a case of tumor-induced osteomalacia resulting from PMT which, although initially clinically suspected, was not localized on octreotide scintigraphy performed several years prior. Subsequent surgical excision of a presumed benign osseous lesion a few years later revealed the diagnosis on pathology. Imaging assessment using Ga-DOTATATE PET/CT following recent clinical suspicion for recurrence revealed an intense tracer-avid lesion at the primary tumor site. DOTATATE imaging plays an important role in localizing tumors with high somatostatin receptor expression, such as neuroendocrine tumors (pheochromocytoma, paraganglioma, and neuroblastoma), meningioma, and mesenchymal tumors, causing oncogenic osteomalacia.
镓标记的生长抑素类似物正电子发射断层扫描/计算机断层扫描（PET/CT）在检测磷酸尿性间叶肿瘤（PMT）方面已显示出优于铟标记的奥曲肽扫描。我们报告一例由PMT引起的肿瘤性骨软化症病例，尽管最初临床上怀疑有该疾病，但在数年前进行的奥曲肽闪烁扫描中未发现其定位。几年后对一个推测为良性的骨病变进行手术切除，术后病理检查明确了诊断。最近临床怀疑复发后，使用镓标记的生长抑素类似物PET/CT进行影像学评估，结果显示在原发肿瘤部位有一个摄取示踪剂强烈的病变。生长抑素类似物成像在定位具有高生长抑素受体表达的肿瘤方面发挥着重要作用，这些肿瘤包括神经内分泌肿瘤（嗜铬细胞瘤、副神经节瘤和神经母细胞瘤）、脑膜瘤以及导致肿瘤性骨软化症的间叶肿瘤。
