Figure 1.

(A) 45/M with polyarthritis for 7 years, progressive weakness of all 4 limbs and wasting of muscles for 5 years. Preoperative biochemical parameters: Serum calcium – 8.2 mg/dL, serum phosphorus – 1.1 mg/dL, serum Vitamin D3 – 14 ng/mL, serum parathyroid hormone – 171 pg/mL, serum alkaline phosphatase – 679 U/L, serum creatinine – 0.6 mg/dL. 99mTechnetium-methylene diphosphonate bone scintigraphy showing a diffuse increase in tracer concentration in axial and appendicular skeleton with microfractures in ribs (arrows) and faint visualization of kidneys suggestive of the metabolic bone disease. (B) Contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography-computed tomography images. (a) Maximum intensity projection image showing physiological tracer distribution and increased fluorodeoxyglucose uptake in the right nasal region. (b) Transaxial and (d) coronal fused contrast enhanced positron emission tomography-computed tomography and corresponding contrast-enhanced computed tomography images showing increased fluorodeoxyglucose uptake (maximum standardized uptake value 5.2) in a soft tissue mass in right nasal cavity with whorl like enhancement on contrast. (c) Low power and (e) high power view photomicrographs showing spindle cell neoplasm with pericytomatous features – possibly sinonasal – type hemangiopericytoma. Postoperative serum calcium – 8.8 mg/dL, serum phosphorus – 3.7 mg/dL