A, Tc-99m-MDP bone scan showing increased tracer uptake at multiple sites. B, Whole-body ¹⁸F-FDG-PET scan revealing FDG avid soft tissue thickening over the radial and dorsal aspect of the head of the right second metacarpal (SUVmax = 2.5). C and D, Fused ¹⁸F-FDG-PET and CT of the right hand in sagittal (C) and coronal (D) planes. E, Histological examination of metacarpal lesion showing diffuse proliferation of bland tumor cells in a patternless arrangement around vessels (F) with bluish smudgy matrix. G, Vimentin positivity on immunohistochemistry. H, Whole-body Ga-68-DOTANOC-PET scan showing avid tracer uptake within left nasal cavity lesion (2.9 × 2.0 cm;, SUVmax, 3.9). I, Fused Ga-68 DOTANOC PET and CT scan head. J, ¹⁸F-FDG-PET SPECT CT head axial imaging demonstrates the left nasal cavity lesion with a low SUV uptake (SUV max = 2.1). K, Histological examination of nasal lesion showing bland tumor cells with fibromyxoid stroma, hemangiopericytomatous pattern of vasculature (arrow). L, Smudgy matrix (arrow). M, Immunohistochemistry shows strong positive staining for somatostatin receptor subtype 2 A (SSTR2A). N, Graph depicting the trends in FGF-23 levels over time.