Ces radiol. 2021, 75(1):61-64 | DOI: 10.55095/CesRadiol2021/007
99mTc-methylene diphosphonate avid talc pleurodesis accidentally detected by bone scintigraphy and SPECT/CT in a 17-year-old osteosarcoma patient with multiple lung metastases - case reportCase report
- 1 Oddělení nukleární medicíny LF UK a FN, Hradec Králové
- 2 Ordinace dětského lékaře, Pediatrie Lejhancová s.r.o., Pardubice
Aim: to present a rare case of non-osseous uptake of the bone-seeking radiopharmaceutical 99mTc-methylene diphosphonate in the area of talc pleurodesis in osteosarcoma patient with multiple pulmonary metastases.
Method: A 17-year-old woman underwent left transfemoral amputation due to the tibial osteosarcoma. Unfortunately, subsequent chemotherapy was ineffective and interim CT revealed multiple lung metastases. Moreover, as a consequence of recurrent bilateral pneumothoraces the talc pleurodesis had to be performed. Two month later, patient suffered from a low-back pain, therefore the bone scan (including both planar imaging and SPECT/CT) was indicated to rule-out osseous metastases.
Results: Whole body scan and additional SPECT/CT of the chest disclosed intensive non-osseous uptake of the bone-seeking radiopharmaceutical in the thickened, calcified pleura as well as osseous metastasis in the sacrum. Regrettably, metastatic involvement of the ribs and thoracic wall could not be ruled-out due to the intensive pleural uptake and subsequent Compton scattering.
Conclusion: Bone scintigraphy with additional SPECT/CT disclosed rare 99mTc-methylene diphosphonate uptake in a talc pleurodesis and metastatic bone involvement.
Keywords: bone scintigraphy, pleurodesis, osteosarcoma, 99mTc-methylene diphosphonate
Grants and funding:
Práce vznikla za podpory MZ ČR - RVO (FNHK).
Accepted: January 31, 2021; Published: March 1, 2021 Show citation
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