我们介绍了一名 63 岁女性，左侧筛窦患有磷酸盐尿性间叶质肿瘤 (PMT)，但没有任何鼻部症状。最初诊断为绝经后骨质疏松症、2 年低磷血症病史以及左侧筛窦中氟 18 (18F)-AlF-NOTA-奥曲肽 (18F-OC) 的摄取量显着升高，为准确诊断提供了重要信息。我们提出患者经历了一年的虚弱和骨痛病史，但在最终做出组织诊断之前没有任何鼻部症状。让患者出现非特异性临床症状是一项具有挑战性的诊断，而且罪魁祸首肿瘤通常体积很小且难以检测。它强调了彻底的患者病史采集和全身功能成像的重要性。鼻窦 PMT 很少见，因此大多数耳鼻喉科医生不熟悉其临床表现。该病例凸显了早期诊断的重要性，以实现及时干预并减轻相关症状的负担。

We present a case of phosphaturic mesenchymal tumor (PMT) in the left ethmoid without any nasal symptoms in a 63-year-old woman. Initially diagnosed with postmenopausal osteoporosis, 2-year history of hypophosphatemia and a significantly higher uptake of Fluorine-18 (18F)-AlF-NOTA-octreotide (18F-OC) in the left ethmoid sinus, provided crucial information for accurate diagnosis.We presented a case with chart review and conducted review of the literature.The patient endured 1-year history of weakness and bone pain but without any nasal symptoms before a tissue diagnosis was eventually reached. It is a challenging diagnosis to make-patients present with non-specific clinical symptoms and the culprit neoplasm is often tiny in size and difficult to detect. It emphasizes the importance of thorough patient history-taking and the whole-body functional imaging.Sinonasal PMTs are rare, and because of this most otolaryngologists are unfamiliar with its clinical presentation. This case highlights the importance of early diagnosis to enable prompt intervention and reduce the burden of associated symptoms.