Incidental Diagnosis of Carcinoma of the Bladder Due to Uptake of 99mTc-MDP

Abstract

An 80-year-old male patient presented to the orthopaedist for evaluation of low backache. A bone scan was performed using 740 MBq (20 mCi) 99m Tc-MDP. Wholebody planar images were acquired 3 h after injection (Fig. 1). The scan revealed normal physiological tracer uptake in skeletal system but irregular and heterogenous accumulation of tracer in the bladder (Fig. 2). To evaluate this abnormal accumulation further, the patient was given a dose of 40 mg furosemide and asked to drink plenty of water. He was instructed to void three to four times within 2-3 h. After 3 h, the urine became less radioactive. An SPECT-CT image of pelvis was acquired, and the images revealed intense multifocal uptake in multiple bladder polyps (Figs. 3, 4). Urine cytology was done, which subsequently revealed malignant cells. Further evaluation with cystoscopic biopsy confirmed transitional cell carcinoma (TCC) of the bladder. Intraoperatively multiple broad based polyps were seen in the dome of the bladder. Transurethral resection of the

Vertical Appearance of Urinary Bladder on Bone Scintigraphy Might Not Always Suggest Adjacent Pathology

“…This case demonstrated that vertical appearance of urinary bladder on bone scintigraphy might not always suggest adjacent pathology. Using SPECT/CT imaging to investigate the abnormal bladder shape could be helpful for accurate image interpretation 9–13 …”

“…Using SPECT/CT imaging to investigate the abnormal bladder shape could be helpful for accurate image interpretation. [9][10][11][12][13]…”