Extraosseous Bone Tracer Accumulation of the Liver on 99mTc-HDP Bone Scintigraphy in Intermittent Bleeding After Iatrogenic Liver Injury

Abstract

A 69-year-old man with common bile duct cancer and deep jaundice had complained of abdominal pain after percutaneous transhepatic biliary drainage. The laboratory workup showed reduction of serum hemoglobin level after the procedure. A 99mTc-hydroxy diphosphonate bone scan was performed for further evaluation of common bile duct cancer, and there was no abnormality of the skeletal structures. However, diffuse and hazy increased radiotracer uptake was detected on the liver. Follow-up contrast-enhanced 99mCT revealed hematoma and subcapsular hemorrhage of the liver.

Extraosseous myocardial uptake incidentally detected during bone scan: report of three cases and a systematic literature review of extraosseous uptake

“…Many unexpected extraosseous uptakes have been reported in literature: although several causes can be addressed, still the majority of cases do not recognize a clear pathological entity [1]. This phenomenon can be due to a huge variety of pathophysiological mechanisms, such as an alteration in calcium metabolism, as it often happens in many systemic diseases, extracellular fl uid expansion and enhanced regional vascularity and permeability [2,3]; lung has been reported to be the most frequently site, followed by myocardium, chest wall. spleen, lymph nodes, kidney, stomach, retroperitoneum, adrenal gland, and pelvic cavity [4][5][6][7][8][9].…”