Case Author(s): Marc Montella, MD and Tom R. Miller, MD, PhD , 6/22/00 . Rating: #D2, #Q4
Diagnosis: Diffuse Metastatic Disease from Prostate Cancer
Brief history:
78 year-old man with right arm pain
Images:
Whole Body Bone Scan
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Spot Images from Whole Body Bone Scan
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Chest Radiograph
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Left Hip Radiograph
Full history/Diagnosis is available below
Diagnosis: Diffuse Metastatic Disease from Prostate Cancer
Full history:
78 year-old male with history of prostate cancer and right arm pain.
Radiopharmaceutical:
20 mCi Tc-99m MDP, i.v.
Findings:
Delayed whole-body scintigrams were obtained. There is diffusely increased activity throughout the axial and appendicular skeleton, with relatively little activity in both kidneys or urinary bladder. The increased bony uptake is in a patchy distribution in both upper extremities. There is decreased activity in the lumbosacral region.
Discussion:
This is a "super scan" appearance with increased bone uptake and little soft tissue activity. This pattern is relatively easily separated from the super scan due to diffuse metabolic disease, most commonly renal osteodystrophy, by the fact that the uptake is heterogeneous. The reduced pelvic activity is due to prior radiation therapy.
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: bs119
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