Occult Maxillary Sinus Phosphaturic Mesenchymal Tumor Localized by 68Ga-DOTATATE PET/CT After Repeated Negative Parathyroid Imaging.
case_report · Level V
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- Also identified by DOI 10.1097/RLU.0000000000006696.
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Abstract
We describe the imaging findings of a phosphaturic mesenchymal tumor arising in the left maxillary sinus in a 34-year-old woman with persistent hypophosphatemia and elevated parathyroid hormone levels who had undergone repeated evaluation for primary hyperparathyroidism despite negative parathyroid imaging. 68Ga-DOTATATE PET/CT demonstrated an unexpected somatostatin receptor-avid lesion in this exceptionally rare location. Surgical resection resulted in rapid biochemical and clinical recovery, while histopathology and single-cell RNA sequencing revealed a distinct FGF23- and PHEX-expressing tumor cell population, providing molecular confirmation of the imaging diagnosis.