99mTc-MDP Uptake in Implantation Metastasis of Gastric Cancer

Abstract

A 47-year-old woman with a history of subtotal gastrectomy due to gastric cancer underwent bone scintigraphy to evaluate possible recurrent disease. The whole-body images revealed a single focus of elevated 99mTc-MDP activity in the right pubic region, which was located in the intrapelvic soft tissue on subsequent SPECT/CT images. Pathological examination after needle biopsy demonstrated that the soft tissue was an implantation metastasis from gastric cancer.

Extraosseous Findings on Bone Scintigraphy Using Fusion SPECT/CT and Correlative Imaging

“…In addition to the histopathologic type of neoplasm, many additional factors, including the degree of inflammation, the presence of necrosis or dystrophic calcifications, angiogenesis, compartmental sequestration, and alterations of the tissue pH, can lead to the accumulation of the radiopharmaceutical [7]. Classically, primary osteosarcoma and its metastases show extraosseous uptake due to bone ma- [6], hypercalcemia a (myeloma, hyperparathyroidism) [6,8,34], gastric metastasis a [21] Liver Liver metastases a [3,4,7,8], aluminum and colloidal impurities, amyloidosis [6], fulminant hepatitis, prior sestamibi imaging Gallbladder Cholecystitis, chemotherapy-related gallbladder uptake a [53] Spleen Sickle cell disease [4,6], Hodgkin and non-Hodgkin lymphoma [6], thalassemia, amyloidosis [6], aluminum and colloidal impurities [7] Peritoneal space Malignant ascites [15], ascites with hepatic failure a [14] Mesentery, omentum, and retroperitoneum…”

“…Other primary malignancies and their metastases may calcify, some with a similar mechanism of binding as the uptake seen in the skeleton [20]. Histopathologic types that often calcify include adenocarcinomas of the colon, ovary, and breast; gastric cancer [21]; and neuroblastoma metastases [8]. Mucin-producing adenocarcinoma may calcify because of internal tumor glycoprotein that binds calcium [22].…”

Elevated 99mTcO4 − Activity in Adenocarcinoma of the Lung

“…Here we reported a case of elevated activity of 99m TcO 4 − in adenocarcinoma of the lung. The increased activity in the soft tissue malignancy on the bone scan has been reported many times before 9–15 …”

“…The increased activity in the soft tissue malignancy on the bone scan has been reported many times before. [9][10][11][12][13][14][15]…”