Usefulness of201Tl and99mTc MIBI scintigraphy in a case of oncogenic osteomalacia

Abstract

A 45-year-old male was admitted with difficulty in walking due to leg pain. At the time of the first visit, a reduced serum phosphorus concentration and an increased serum alkaline phosphatase concentration of unknown etiology were observed. Either a whole body bone scintigraphy or CT of the neck, chest and abdominal region did not reveal any underlying disease. However both the whole body 201Tl scintigraphy and 99mTc MIBI SPECT showed accumulation in the right knee region, and a small tumor was detected by MRI examination. After a diagnosis of oncogenic osteomalacia due to this tumor was determined the tumor was surgically removed, and turned out to be a hemangiopericytoma. By removal of the tumor, either the symptoms or the laboratory data were improved significantly. In this case, both 201Tl scintigraphy and 99mTc scintigraphy MIBI were useful in identifying the location of the tumor which caused oncogenic osteomalacia.

Oncogenic Osteomalacia Caused by Phosphaturie Mesenchymal Tumours in the Proximal and Shaft of the Tibia: A Case Report

“…Investigation tools include MRI, [13][14][15][16][17][18][19] octreotide scintigraphy, [20][21][22][23][24][25] 201 TI scintigraphy, 26 99m Tc-MIBI scintigraphy, 26,27 and F-18 FDG positron emission tomography (PET) [28][29][30] (Table). MRI is the investigation of choice owing to its high sensitivity.…”

Osteomalácia oncogênica: cintilografia com sestamibi-99mTc na localização do tumor

“…A recomendação feita, até recentemente, era a de realizar tomografi a computadorizada e ressonância magnética de mandíbula e seios da face, não obstante a baixa sensibilidade de ambos os métodos em localizar tais neoplasias, principalmente as do tecido conjuntivo (5)(6)(7)18).…”

“…Expõe menor dose de radiação ao paciente e maior disponibilidade em nosso meio. Com sucesso, também, na localização destes pequenos tumores, mostra tendência de que este mé-todo venha a ser o mais adequado para a pesquisa inicial (4,5).…”

PET/CT Localization of Phosphaturic Mesenchymal Neoplasm Causing Tumor-Induced Osteomalacia

“…CT, MRI, 11 In-111 pendetreotide, 12,13 Tc-99m sestamibi and Tl-201 chloride 14 imaging have all been reported to successfully localize the tumor. PET/CT has recently been reported as effective, and, when combined with serum FGF-23 measurement, is perhaps superior to these other techniques.…”