Case Author(s): virginia klaas , Henry Royal , 6-2-95 . Rating: #D2, #Q3

Diagnosis: Metastases, hypercalcemia, barium artifact

Brief history:

65 year old male with laryngeal carcinoma. Rule out metasases.


anterior and posterior whole body images.

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Full history/Diagnosis is available below

Diagnosis: Metastases, hypercalcemia, barium artifact

Full history:

65-year old man with known laryngeal carcinoma, which was resected approximately six months ago. The patient is now referred to rule out bony metatases.


Whole body bone scintigraphy demonstrates multiple foci of increased uptake in the axial and appendicular skeleton, which are most consistent with bone metastases. Additionally, there is persistent increased uptake in both kidneys. A curvilinear region of absent uptake is seen over the left kidney on the anterior view which correlates with residual barium from an upper GI performed one day prior to bone scintigraphy.


Although extensive metastases is somewhat unusual in patients with laryngeal carcinoma, computed tomography demonstrated multiple pulmonary nodules, mediastinal adenopathy, and bone destruction. Therefore, the scintigraphic findings in this patient do correlate with bone metastases. The differential diagnosis of persistent increased uptake in both kidneys includes dehydration, hypercalcemia, prior chemotherapy or radiation therapy. The increased uptake in this patient was known to be related to hypercalcemia, which was documented by laboratory data.



Major teaching point(s):

See discussion

ACR Codes and Keywords:

References and General Discussion of Bone Scintigraphy (Anatomic field:Skeletal System, Category:Neoplasm, Neoplastic-like condition)

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Case number: bs025

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