Diffuse Increased 68Ga-DOTATATE But Unimpressive 18F-FDG Osseous Activity in a Patient With Rapid-Progressing Synchronous Multifocal Osteosarcoma

Osteosarcoma is usually F-FDG-avid. Here we report a case of an 18-year-old young man with widespread osteoblastic and slight osteolytic changes, which had diffusely increased Ga-DOTATATE uptake in the osseous lesions, whereas the F-FDG PET/CT was unrevealing. The final diagnosis is synchronous multifocal osteosarcoma based on the pathological, clinical, and imaging features.