Aim: Utility of Ga68 DOTATATE PETCT imaging to localise cause for oncogenic osteomalacia (OOM).
Materials And Methods: Retrospective analysis between March 2015 to March 2018 of all patients with a clinical diagnosis (based on a combination of clinical history, hypophosphatemia and elevated FGF-23 values) of OOM who underwent Ga-68 DOTATATE PET/CT.
Results: Total of 27 patients had undergone Ga-68 DOTATATE PET/CT imaging in our centre from March 2015 to March 2018. Of these 16 patients with clinically suspected oncogenic osteomalacia were included in our study. Age range 18-61 years of which 12 were males. Total of 13 (81.25%) patients were found to be positive on imaging for a possible mesenchymal tumour. Most common site of tumour was the lower limb (76%). Most common presenting symptom was bone pain (81%) followed by muscle weakness (19%). Overall, 10 patients underwent surgery, all of whose biopsy was reported as phosphaturic mesenchymal tumour. During the three month follow up, serum phosphorous measured in 15/16, post-surgical/ medical treatment had normalised in all except two patients who had undergone only medical therapy with neutral phosphate. Fall in FGF-23 was more pronounced in surgically treated patients as compared to those who received medical treatment.
Conclusion: Ga68-DOTATE PET/CT is a useful investigatory modality for localizing cause for oncogenic osteomalacia.
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http://dx.doi.org/10.4103/ijnm.IJNM_14_19 | DOI Listing |
Oxf Med Case Reports
December 2024
Department of Chemical Pathology & Metabolic Diseases, University Hospitals of Leicester NHS Trust, Groby Road, Leicester LE39QP, United Kingdom.
Tumour-induced osteomalacia (TIO), also known as oncogenic osteomalacia, is a rare paraneoplastic syndrome mediated by the overproduction of phosphaturic hormone fibroblast growth factor 23. TIO is most commonly caused by mesenchymal tumours (PMTs), which are typically small, slow-growing and often undetectable on physical examination and conventional imaging techniques. Patients with TIO typically undergo a protracted period of diagnostic workup and medical treatment due to presentation with nonspecific symptoms and difficulty in localising the culprit tumour.
View Article and Find Full Text PDFRev Endocr Metab Disord
December 2024
Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
Intravenous iron supplementation is increasingly used to safely and effectively correct iron deficiency anemia, but some formulations are linked to a renal phosphate wasting syndrome which is mediated by fibroblast growth factor 23. Unawareness among prescribers and the nonspecific clinical symptoms of hypophosphatemia result in underreporting of this complication. Even though it is often an asymptomatic and self-limiting condition, accumulating evidence from case reports and dedicated randomized controlled trials show that IV iron induced hypophosphatemia may be associated with clinical symptoms.
View Article and Find Full Text PDFFront Endocrinol (Lausanne)
December 2024
Department of Orthopedics and Trauma, Weifang People's Hospital, First Affiliated Hospital of Shandong Second Medical University, Weifang, China.
Objective: This study aims to report the application of 18F-AlF-NOTA-Octreotide PET/CT and 3D printing technology in the diagnosis and treatment of phosphaturic mesenchymal tumors (PMT) in patients with tumor-induced osteomalacia (TIO).
Case Presentation: A 68-year-old male patient (Case 1) was admitted to the Weifang People's Hospital in August 2022 with complaints of "persistent pain in the bilateral flank and lumbosacral region". 18F-AlF-NOTA-Octreotide PET/CT showed high octreotide expression in the left femoral region.
Clin Nucl Med
January 2025
From the Department of Endocrinology, Seth G S Medical College.
A 42-year-old man, a known case of FGF23-dependent hypophosphatemia, underwent 68 Ga- DOTATATE PET-CT, which showed a somatostatin receptor-expressing lesion in the left arch of foramen magnum that was correlated on MRI as a soft tissue lesion measuring 2.2 × 1.3 cm.
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