Tumor-induced osteomalacia (TIO) is an acquired form of hypophosphatemia. Tumor resection leads to cure. We investigated the clinical characteristics of TIO, diagnostic methods, and course after tumor resection in Beijing, China, and compared them with 269 previous published reports of TIO. A total of 94 patients with adult-onset hypophosphatemic osteomalacia were seen over a 6-year period (January, 2004 to May, 2010 in Peking Union Medical College Hospital. After physical examination (PE), all patients underwent technetium-99m octreotide scintigraphy ( 99 Tc m -OCT). Tumors were removed after localization. The results demonstrated that 46 of 94 hypophosphatemic osteomalacia patients had high uptake in 99 Tc m -OCT imaging. Forty of them underwent tumor resection with the TIO diagnosis established in 37 patients. In 2 patients, the tumor was discovered on PE but not by 99 Tc m -OCT. The gender distribution was equal (M/F ¼ 19/20). Average age was 42 AE 14 years. In 35 patients (90%), the serum phosphorus concentration returned to normal in 5.5 AE 3.0 days after tumor resection. Most of the tumors (85%) were classified as phosphaturic mesenchymal tumor (PMT) or mixed connective tissue variant (PMTMCT). Recurrence of disease was suggested in 3 patients (9%). When combined with the 269 cases reported in the literature, the mean age and sex distribution were similar. The tumors were of bone (40%) and soft tissue (55%) origins, with 42% of the tumors being found in the lower extremities. In summary, TIO is an important cause of adult-onset hypophosphatemia in China. 99 Tc m -OCT imaging successfully localized the tumor in the overwhelming majority of patients. Successful removal of tumors leads to cure in most cases, but recurrence should be sought by long-term follow-up. ß

SAPHO syndrome is predominant in middle-age women, characterized by dermatological and osteoarticular manifestations with unknown aetiology. CT scan and bone scintigraphy are useful for diagnosis. There is still no standard treatment to control the disease.

Adenosine-stress CT perfusion detects myocardial perfusion defects in good correlation with nuclear MPI. CT perfusion combined with CTA improves the diagnostic accuracy for identifying flow-obstructing stenosis compared with CTA alone.

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(68)Ga DOTATATE PET/CT scan is an accurate imaging modality in the detection of tumors causing TIO.

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In this investigation, the efficacy of scintigraphy using 99m Tclabeled hydrazinonicotinyl-Tyr3-octreotide (HYNIC-TOC) in the evaluation of extraadrenal pheochromocytoma was assessed and compared with 131 I-labeled metaiodobenzylguanidine (MIBG) imaging. Methods: Ninety-seven patients who were suspected of having pheochromocytoma but showed no definite adrenal abnormalities on CT were evaluated by both 99m Tc-HYNIC-TOC scintigraphy and 131 I-MIBG imaging. The results were compared with pathology findings or clinical follow-up. Results: Of 58 patients proven to be without pheochromocytoma, 99m Tc-HYNIC-TOC and 131 I-MIBG imaging excluded 56 and 58 patients, respectively, rendering a specificity of 96.6% for 99m Tc-HYNIC-TOC imaging and 100% for 131 I-MIBG imaging. In the evaluation of adrenal pheochromocytoma (14 patients), the sensitivity of 99m Tc-HYNIC-TOC scintigraphy and 131 I-MIBG imaging was 50% and 85.7%, respectively. However, in the evaluation of extraadrenal pheochromocytomas (25 patients), the sensitivity of 99m Tc-HYNIC-TOC scintigraphy and 131 I-MIBG imaging was 96.0% and 72.0%, respectively. Conclusion: 99m Tc-HYNIC-TOC scintigraphy is more sensitive than 131 I-MIBG imaging in the detection of extraadrenal pheochromocytomas.Key Words: extraadrenal pheochromocytoma; 99m Tchydrazinonicotinyl-tyr3-octreotide (HYNIC-TOC); metaiodobenzylguanidine (MIBG)

BackgroundPrimary idiopathic chylopericardium is a rare clinical entity characterized by the accumulation of chyle within the pericardial cavity without a definitive cause. The aim of this study was to assess the clinical presentation, etiology, diagnosis, treatment and follow-up of primary idiopathic chylopericardium.MethodsWe retrospectively reviewed 9 cases of patients who suffered from primary idiopathic chylopericardium at our hospital from January 1993 to November 2013.ResultsThere were two males and seven females among our patients. Their ages ranged from 13 to 55 years. The most common clinical presentation was dyspnea. The etiology was idiopathic. All patients were diagnosed by pericardiocentesis, computed tomography of the chest and lymphoscintigraphy. Non-surgical therapy was adopted in all nine patients and failed in six, who underwent subsequent successful surgery. Thoracic duct ligation with the creation of a pericardial window was the most common surgical procedure. All patients were followed up from 3 months to 9 years, and no recurrence occurred.ConclusionsIn assessing patients with an enlarged cardiac silhouette, one should be aware of primary idiopathic chylopericardium. The most effective treatment is ligation of the thoracic duct and the creation of a pericardial window.