en Radiation Biology Radiation Biology مطالعه موردي Case Report <div style="text-align: justify;"><span style="font-size:10pt"><span style="text-justify:newspaper"><span style="text-kashida-space:50%"><span style="line-height:119%"><span style="font-family:Calibri"><span style="color:black"><span lang="en-US" style="font-family:Calibri"><span style="color:black"><span style="language:en-US">Phosphate absorption can be blocked by over-the-counter antacids, such as calcium- magnesium-, and aluminum-containing products.</span></span></span> <span lang="en-US" style="font-family:Calibri"><span style="color:black"><span style="language:en-US">Although it is rare to see hypophosphatemia induced by aluminum-containing antacids, the combination treatment using two kinds of aluminum-containing agents may significantly increase the risk of hypophosphatemia in clinical settings. We present a case of hepatocellular carcinoma, showing multiple hot spots while being investigated for metastatic cancer in a routine bone scan. Initial laboratory studies showed hypophosphatemia. Long-term treatment for upper gastrointestinal bleeding with antacids and sucralfate was remarkable in the patient&rsquo;s past history. Compared with corresponding radiographic findings, multiple areas of increased uptake on the bone scan are consistent with osteomalacia and microfractures. This case demonstrates that antacid and sucralfate-induced osteomalacia can mimic bony metastasis in a hepatocellular carcinoma patient on bone scintigraphy. Additional imaging modality, laboratory surveillance or follow-up bone scintigraphy may be recommended for accurate diagnosis or an appropriate treatment plan for the patient.</span></span></span></span></span></span></span></span></span></div> Bone scan, antacid, sucralfate, hypophosphatemic osteomalacia. 173 176 http://ijrr.com/browse.php?a_code=A-10-1-1024&slc_lang=en&sid=1 Y-W Chuang 7900319475328460024545 7900319475328460024545 No Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan H-P Chan 7900319475328460024546 7900319475328460024546 No Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan C-Y Lin 7900319475328460024547 7900319475328460024547 No Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan Y-F Huang 7900319475328460024548 7900319475328460024548 No Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan C-C Hsu 7900319475328460024549 7900319475328460024549 No Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan C-C Chang 7900319475328460024550 7900319475328460024550 No Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan D. H-Y Shen 7900319475328460024551 7900319475328460024551 No Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan K-P Chuang 7900319475328460024552 7900319475328460024552 No Graduate Institute of Animal Vaccine Technology, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, 912, Taiwan M-H Yang mhyang@vghks.gov.tw 7900319475328460024553 7900319475328460024553 Yes Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan Y-C Tyan yctyan@kmu.edu.tw 7900319475328460024554 7900319475328460024554 No Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan