Early Stage of Tumour-Induced Osteomalacia

e patient had persistent hypophosphatemia with elevated serum fibroblast growth factor (FGF) 23 levels (100 pg/ml). 68Ga-DOTATATE PET/CT (Computed tomography) showed a somatostatin-receptor-expressing lesion in the cribriform plate and left sphenoethmoidal recess.Surgical excision of the lesion showed a spindle cell neoplasm, consistent with a phosphaturic mesenchymal tumour.Normal radiographs and dual-energy X-ray absorptiometry (DEXA) scan suggested early-stage disease without overt skeletal changes.is case highlights the utility of 68 Ga-DOTATATE PET/CT in detecting tumour-induced osteomalacia even in the early stages when conventional imaging studies are negative. [1