title: An unusual case of a tibial metastasis as the clinical presentation of bronchogenic adenocarcinoma.
abstract: A patient with initial complaints of leg pain and difficulty walking was found to have a large right tibial metastatic tumor and poorly differentiated adenocarcinoma of the lung. Findings from total-body bone scintigraphy include a large area of increased uptake in the proximal half of the right tibia with a photon-deficient area medially, and focal areas of uptake in a right rib, in the femoral neck and the left ileum. An irregular area of increased uptake in the left lung mass was shown by thoracic bone SPECT. This is an unusual case of a tibial metastasis as the first clinical presentation of bronchogenic adenocarcinoma.
authors.affiliation: Nuclear Medicine Service, Veterans Administration Medical Center, Lexington, Kentucky 40511-1093, USA.
authors.forename: W J
authors.initials: WJ
authors.lastname: Shih
authors.forename: S
authors.initials: S
authors.lastname: Magoun
authors.forename: B
authors.initials: B
authors.lastname: Lahar
authors.forename: V
authors.initials: V
authors.lastname: Stipp
authors.forename: K
authors.initials: K
authors.lastname: Gross
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary*; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D005272:Femur Neck / Q000000981:diagnostic imaging; D006801:Humans; D007078:Ileal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D007082:Ileum / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D019275:Radiopharmaceuticals; D012272:Ribs / Q000000981:diagnostic imaging; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives; D013977:Tibia / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D014915:Whole-Body Counting
chemical_list: D019275:Radiopharmaceuticals; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate