Tumor-Induced Osteomalacia Localized to an Abdominal Wall Phosphaturic Mesenchymal Tumor by 68Ga-DOTATATE PET/CT

A ⁶⁸Ga-DOTATATE PET/CT scan was performed on a 40-year-old woman with suspected tumor-induced osteomalacia (TIO), who presented with progressive bone pain, multiple fractures, and hypophosphatemia. The scan revealed a solitary focus of intense somatostatin receptor avidity within the right lower abdominal wall musculature. No other suspicious lesions were identified. On the basis of this finding, the tumor was surgically resected, and histopathology confirmed a phosphaturic mesenchymal tumor (PMT). Postoperatively, the patient's serum phosphate levels normalized. This case underscores the paramount value of ⁶⁸Ga-DOTATATE PET/CT in localizing occult PMTs, even in uncommon locations like the abdominal wall, guiding definitive surgical management.