PMC6923526_01
Intense focally increased uptake within a 0.5-cm lytic bony lesion in the
anteromedial proximal right fibular cortex (arrow), consistent with the
culprit mesenchymal tumor producing tumor induced osteomalacia.
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FGF23 prompted a search for a latent neoplasm causing TIO. Functional imaging was ordered, and an octreotide scan showed a right proximal fibular mesenchymal tumor (Figure 1).
Magnetic resonance imaging of solid intramuscular tumor corresponding to
octreotide avid lesion.
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Anatomical imaging (magnetic resonance imaging) confirmed the findings (Figure 2).
Serum phosphorus trend over 3 months, with an increase seen post tumor
excision.
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PTH levels normalized to 50 ng/mL and 4 mg/dL, respectively (Figure 3). Patient reported satisfaction with significant improvement in her bone pain and also complete resolution of her psychiatric symptoms.