case_images: PMC7067133_01
case_images: Coronal maximum intensity projection images of the initial octreotide scan. No abnormal octreotide uptake was seen
case_images: WJNM-19-78-g001.jpg
case_images: PMC7067133_01_WJNM-19-78-g001.jpg
case_images: F1
case_images: In order to evaluate TIO, an 111Indium-octreotide scan was performed 2 years later but returned negative [Figure 1].
case_images: Coronal short tau inversion recovery (a) and axial T2 images (b) of magnetic resonance imaging through left ischium demonstrating slight short tau inversion recovery hyperintense lesion (red arrow)
case_images: WJNM-19-78-g002.jpg
case_images: PMC7067133_01_WJNM-19-78-g002.jpg
case_images: F2
case_images: An unenhanced magnetic resonance imaging (MRI) performed for the left hip pain 7 years ago presumed benign fibro-osseous lesion versus enchondroma in the left ischium [Figure 2].
case_images: Preincisional biopsy imaging examinations. Axial computed tomography image (a) showing osteolytic lesion in the left ischium with internal matrix small calcifications and disruption of medial cortex. Sagittal T1 (b) and axial T1 (c) magnetic resonance imaging images showing left ischial-enhancing T1 hypointense lesion (orange arrow) (d). Metal-related artifacts on computed tomography and magnetic resonance are noted from left femur neck instrumentation
case_images: WJNM-19-78-g003.jpg
case_images: PMC7067133_01_WJNM-19-78-g003.jpg
case_images: F3
case_images: Cam-type femoroacetabular impingement, he had a femur neck fracture that was instrumented. CT and contrast-enhanced MRI performed for persistent left ischial pain were concerning for chondroid neoplasm [Figure 3].
case_images: Most recent 68Ga-DOTATATE positron emission tomography/computed tomography. Anatomic axial computed tomography image (a) showing mixed lytic and sclerotic focus in the left ischium (orange arrow) that shows corresponding focal increased uptake on the fused positron emission tomography images (b-d) and maximum intensity projection image (e)
case_images: WJNM-19-78-g004.jpg
case_images: PMC7067133_01_WJNM-19-78-g004.jpg
case_images: F4
case_images: Hypophosphatemia gradually resolved following surgery, until recently, when serum phosphorus level dropped to 2.3 mg/dl (normal 2.5-4.5 mg/dL). 68Ga-DOTATATE PET/CT scan revealed radiotracer uptake in the left ischium suggesting the recurrence of PMT, the initial cause for TIO in this patient [Figure 4].