Unusual bilateral Tc-99m DPD uptake on bone scan.
A 74-year-old man with prostate cancer was screened for bone metastases. The scan exhibited severe degenerative skeletal changes (especially in the spine and the right knee) and catheter drainage of the bladder, but obviously no bone metastases. Surprisingly, 2 almost symmetric "devil-like"-looking lesions were noted in the frontolateral skull. The patient was treated with bilateral bore hole trepanation because of a subdural hematoma 3 weeks earlier. The lesions can be interpreted as augmented bone metabolism in these regions. Although subdural hematoma is fairly common (incidence, 15:100,000 annually), bilateral trepanation is only performed in approximately 5% of patients.
Department of Nuclear Medicine, University Hospital Freiburg, Germany. smerk@ukl.uni-freiburg.de
Stefan
S
Merk
Michael
M
Hentschel
Jochen
J
Talazko
Richard
R
Fischer
Ernst
E
Moser
D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D004164:Diphosphonates; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D015609:Organotechnetium Compounds; D011471:Prostatic Neoplasms / Q000473:pathology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012886:Skull / Q000000981:diagnostic imaging; D014207:Trephining
D004164:Diphosphonates; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C033905:technetium Tc 99m 1,1-diphosphonopropane-2,3-dicarboxylic acid