{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:20:29Z","timestamp":1772158829558,"version":"3.50.1"},"reference-count":14,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Tumor-induced osteomalacia is characterized by hypophosphatemia and fragility fractures caused by fibroblast growth factor 23 (FGF23)-producing tumors. We report a case of tumor-induced osteomalacia in which the tumor location could be determined by gallium 68 (68Ga)-DOTATOC positron emission tomography (PET)\/computed tomography (CT). A 74-year-old woman had recurrent fractures and bone pain. Blood tests showed hypophosphatemia and elevated serum alkaline phosphatase and FGF23 levels and CT and bone scintigraphy showed multiple bone fractures. Tumor-induced osteomalacia was therefore suspected. Indium 111 (111In)-pentetreotide scintigraphy showed focus of increased activity in the head, and CT and magnetic resonance images showed a mass-like lesion in the posterior ethmoidal sinus. However, in systemic venous sampling, serum FGF23 level was highest in the left common iliac vein. 68Ga-DOTATOC PET\/CT clearly demonstrated focal uptake in the left anterior inferior iliac spine consistent with systemic venous sampling. Retrospectively analyzed, focal uptake in the head was considered to be a physiological uptake in the pituitary gland. The tumor was resected and the pathological diagnosis was phosphaturic mesenchymal tumor. A combination of systemic venous sampling and 68Ga-DOTATOC PET\/CT was useful in detection of a small FGF23-producing tumor. Precise tumor localization in such cases requires careful interpretation of scintigraphy.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf012","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T10:40:00Z","timestamp":1737715200000},"source":"Crossref","is-referenced-by-count":1,"title":["Tumor-Induced Osteomalacia Localized by Systemic Venous Sampling and 68Ga-DOTATOC Positron Emission Tomography"],"prefix":"10.1210","volume":"3","author":[{"given":"Tomomi","family":"Nakao","sequence":"first","affiliation":[{"name":"First Department of Internal Medicine, Wakayama Medical University , Wakayama City, Wakayama 641-8509 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2364-5018","authenticated-orcid":false,"given":"Ken","family":"Takeshima","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, Wakayama Medical University , Wakayama City, Wakayama 641-8509 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4415-3805","authenticated-orcid":false,"given":"Shuhei","family":"Morita","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, Wakayama Medical University , Wakayama City, Wakayama 641-8509 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4236-502X","authenticated-orcid":false,"given":"Ichiro","family":"Yamauchi","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine , Kyoto 606-8507 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sho","family":"Koyasu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kyoto University Hospital , Kyoto 606-8507 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taka-Aki","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, Wakayama Medical University , Wakayama City, Wakayama 641-8509 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"issue":"3","key":"2025020513064333600_luaf012-B1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/joim.13593","article-title":"Global guidance for the recognition, diagnosis, and management of tumor-induced osteomalacia","volume":"293","author":"Jan de Beur","year":"2023","journal-title":"J Intern Med"},{"issue":"8","key":"2025020513064333600_luaf012-B2","doi-asserted-by":"crossref","first-page":"e3428","DOI":"10.1210\/clinem\/dgac253","article-title":"Tumor-induced osteomalacia: a systematic review and individual Patient's data analysis","volume":"107","author":"Rendina","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"2025020513064333600_luaf012-B3","doi-asserted-by":"crossref","first-page":"116064","DOI":"10.1016\/j.bone.2021.116064","article-title":"Challenges in the management of tumor-induced osteomalacia (TIO)","volume":"152","author":"Brandi","year":"2021","journal-title":"Bone"},{"issue":"8","key":"2025020513064333600_luaf012-B4","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1002\/jbmr.4620","article-title":"Clinical challenges in diagnosis, tumor localization and treatment of tumor-induced osteomalacia: outcome of a retrospective surveillance","volume":"37","author":"Hidaka","year":"2022","journal-title":"J Bone Miner Res"},{"issue":"1","key":"2025020513064333600_luaf012-B5","doi-asserted-by":"crossref","first-page":"2","DOI":"10.3390\/diagnostics10010002","article-title":"Detection rate of culprit tumors causing osteomalacia using somatostatin receptor PET\/CT. 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