title: Extraosseous uptake of technetium-99m methylene diphosphonate by an acute territorial cerebral infarct in a classical biodistribution pattern.
abstract: Technetium-99m methylene diphosphonate scintigraphy is usually performed to assess bone lesions, especially skeletal metastases in patients with a history of malignancy. However, it is important to recognize some specific conditions with a unique pattern of tracer uptake, especially in extraosseous locations as they are not related to primary neoplasm or metastases. Diagnosing such unusual presentation is essential as it significantly influences the clinical management. This case report describes an unusual presentation detected in a bone scan of an elderly female patient, who was a treated case of breast cancer and was referred for a bone scan to rule out bone metastases. Incidentally, a large acute territorial cerebral infarct was diagnosed, which was later confirmed by magnetic resonance imaging on diffusion-weighted images. Diagnosis of the typical presentation and timely management saved the patient life.
authors.affiliation: Department of Nuclear Medicine and PET, Singapore General Hospital, Singapore 1696082, Republic of Singapore ; Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore 768228, Republic of Singapore.
authors.forename: Anbalagan
authors.initials: A
authors.lastname: Kannivelu
authors.affiliation: Department of Nuclear Medicine and PET, Singapore General Hospital, Singapore 1696082, Republic of Singapore.
authors.forename: Ajit Kumar
authors.initials: AK
authors.lastname: Padhy
authors.affiliation: Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore 768228, Republic of Singapore.
authors.forename: Sivasubramanian
authors.initials: S
authors.lastname: Srinivasan
authors.affiliation: Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore 768228, Republic of Singapore.
authors.forename: Syed Zama
authors.initials: SZ
authors.lastname: Ali
keywords: Acute cerebral infarct; extraosseous bone tracer uptake; skeletal metastases; technetium-99m methylene diphosphonate scintigraphy