technetium-tc-99m-medronate and Carcinoma--Bronchogenic

A 54-year-old man with bronchogenic adenocarcinoma had features of the hypertrophic osteoarthropathy syndrome. The syndrome is treated by surgical resection of the primary tumor, with rapid remission of the symptoms within 24 hours after surgery. In the case reported here, the tumor (T3N3M0) could not be resected. Clinical and scintigraphic regression of the hypertrophic osteoarthropathy was evident after chemotherapy. Bone scintigraphy is valuable when determining a patient's response to treatment for this paraneoplastic syndrome.

Topics: Bone and Bones; Carcinoma, Bronchogenic; Humans; Lung Neoplasms; Male; Middle Aged; Osteoarthropathy, Secondary Hypertrophic; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

To assess the prognostic significance of hypertropic osteoarthropathy (HOA) discovered on routine staging bone scintigraphy in patients with lung cancer.. Between 1989 and 1992 all 99mTc-MDP bone scintigrams performed for the staging of bronchogenic carcinoma were reviewed. HOA was diagnosed by the observation of cortical/periosteal increased uptake in the extremities of the long bones. Follow-up and confirmation of the diagnosis was obtained by hospital computer, histology records, operative records, patient notes and radiological data where available.. 164 staging scintigrams for lung cancer were identified. Twenty-eight patients (17%) were observed to have HOA. Patients with and without HOA were well matched for age and sex. There was little difference in the distribution of cell type but the HOA groups has a greater incidence of peripheral tumours. There was no significance in survival between the two groups. Two of three long-term survivors had clinically overt HOA and one presented with arthralgia.. HOA is often seen on skeletal scintigraphy for staging of lung cancer and has no prognostic significance. The data also support current teaching that a high index of suspicion for HOA, as a cause of arthralgia may lead to early diagnosis of a potentially resectable lung carcinoma.

Topics: Aged; Aged, 80 and over; Carcinoma, Bronchogenic; Female; Follow-Up Studies; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Staging; Osteoarthropathy, Secondary Hypertrophic; Paraneoplastic Syndromes; Prognosis; Radionuclide Imaging; Survival Rate; Technetium Tc 99m Medronate

A 52-year-old man with metastatic poorly differentiated bronchogenic carcinoma and serum calcium levels as high as 14.6 had intense Tc-99m MDP uptake found throughout the stomach wall on SPECT imaging. FDG uptake assessed by PET imaging was not elevated in the stomach, whereas multiple hyper-metabolic tumor foci could be found throughout the body. Three months later, when calcium levels normalized, no Tc-99m MDP uptake was found in the stomach despite persistence of neoplastic lesions elsewhere. This case study indicates that gastric MDP uptake in patients with malignancy related hypercalcemia can be reversible and not necessarily indicative of neoplastic infiltration.

Topics: Bone Neoplasms; Carcinoma, Bronchogenic; Deoxyglucose; Fluorine Radioisotopes; Fluorodeoxyglucose F18; Humans; Hypercalcemia; Lung Neoplasms; Male; Middle Aged; Stomach; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon

Carpal bone is an uncommon location for metastases, and diagnostic problems can occur when a solitary metastasis mimics acute arthritis or osteomyelitis clinically as well as radiologically.

Topics: Bone Neoplasms; Carcinoma, Bronchogenic; Carpal Bones; Humans; Lung Neoplasms; Male; Middle Aged; Radiography; Radionuclide Imaging; Technetium Tc 99m Medronate

Two cases are reported in which bone imaging with Tc-99m MDP showed sternal areas without tracer uptake corresponding to bone metastases compromising blood supply to the sternum itself. Radiographs were normal in both cases.

Topics: Adult; Aged; Bone Neoplasms; Breast Neoplasms; Carcinoma, Bronchogenic; Female; Humans; Lung Neoplasms; Male; Neoplasms, Multiple Primary; Radionuclide Imaging; Sternum; Technetium Tc 99m Medronate

A patient with squamous cell carcinoma of the lung had splenic uptake of Tc-99m MDP on two consecutive bone scans, but not on a third. There was no intervening therapy. At autopsy the spleen was grossly and microscopically normal.

Topics: Bone and Bones; Carcinoma, Bronchogenic; Carcinoma, Squamous Cell; Diphosphonates; Humans; Lung Neoplasms; Male; Middle Aged; Radionuclide Imaging; Spleen; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

In two patients with metastatic disease more lesions were detected on scintigraphs obtained with the 'low uptake' bone-scanning agent dimethyl-amino-diphosphonate. The results in these two patients provide practical support for the suggestion that bone-scanning agents with low uptake in normal bone, but high tumour-to-normal bone ratios, will allow better delineation of focal bone abnormalities.

Topics: Aged; Bone Neoplasms; Carcinoma, Bronchogenic; Diphosphonates; Humans; Lung Neoplasms; Male; Middle Aged; Organotechnetium Compounds; Prostatic Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

The presence of the "hot patella" sign was evaluated in a prospective study of 200 consecutive bone scans, and in a review of scans from 148 patients with various metabolic bone disorders and 61 patients with lung carcinoma. The incidence was found to be 31%, 26% and 31% respectively. This sign is an extremely common scan finding and may be seen in association with a wide variety of disorders. It is concluded that this sign cannot be considered to be of diagnostic value.

Topics: Adult; Aged; Bone and Bones; Bone Diseases, Metabolic; Carcinoma, Bronchogenic; Diphosphonates; Humans; Lung Neoplasms; Middle Aged; Patella; Prospective Studies; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Bone and Bones; Brain; Carcinoma, Bronchogenic; Diphosphonates; Humans; Liver; Lung Neoplasms; Preoperative Care; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate