technetium-tc-99m-medronate and Carcinoma--Ductal--Breast

Super scan pattern on technetium-99m methyldiphosphonate (Tc-99m MDP) bone scintigraphy is a special condition of extremely high bone uptake relative to soft tissue with absent or faint renal radioactivity visualization, which is usually seen in diffuse bone metastases or discrete endocrine entities. Here, two cases with super bone scan are presented. One was a young man diagnosed with gastric cancer. The other was a middle-aged woman with a history of breast cancer with recent recurrence. Both cases had 18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) diagnosis simultaneously. Based on imaging of (18)F-FDG PET/CT, diffusely incremental (18)F-FDG avidity in spine/pelvis on PET and subtle erosion of cortical bone on CT were seen. The cytological results of bone marrow biopsy showed evidence of malignant metastasis. However, there were several focal discrepant findings between the (18)F-FDG PET/CT and Tc-99m MDP bone scan. According to integration of both imaging findings and the result of bone marrow biopsy, we believe that the disseminated malignant spread in bone marrow is a primitive alternation in the super bone scan and that it is also as a result of neoplasm-related endocrine factors.

Topics: Adult; Bone Marrow Neoplasms; Bone Neoplasms; Breast Neoplasms; Carcinoma, Ductal, Breast; Diagnosis, Differential; Female; Fluorodeoxyglucose F18; Humans; Male; Middle Aged; Multimodal Imaging; Neoplasms, Unknown Primary; Positron-Emission Tomography; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Adult; Artifacts; Axilla; Biopsy; Breast Diseases; Breast Neoplasms; Carcinoma; Carcinoma, Ductal, Breast; Chemotherapy, Adjuvant; Drug Resistance, Multiple; Drug Resistance, Neoplasm; False Positive Reactions; Female; Forecasting; Humans; Lymphatic Metastasis; Magnetic Resonance Imaging; Mammography; Middle Aged; Multicenter Studies as Topic; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Organophosphorus Compounds; Organotechnetium Compounds; Patient Selection; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Thallium Radioisotopes; Ultrasonography

Topics: Bone Neoplasms; Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Follow-Up Studies; Humans; Middle Aged; Radionuclide Imaging; Tarsal Bones; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Axilla; Breast; Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Assessment of bone marrow metastases using Tc-99m-labeled antigranulocyte antibodies and Tc-99m-labeled nanocolloids is discussed in osseous metastasizing breast cancer. A 53-year-old patient with bone metastases of breast cancer (pT2 pN1biv cM1) developed leukocytopenia WHO Grade III following polychemotherapy. Bone marrow scintigraphy with Tc-99m labeled nanocolloids and Tc-99m-labeled antigranulocyte antibodies revealed pronounced bone marrow infiltration as the cause. Comparing both procedures, the images with antigranulocyte antibodies showed a clearly better bone marrow image, considerably higher contrast and almost no superimposition of the liver over the spine. In osseous metastasizing breast cancer, scintigraphy with Tc-99m-labeled antigranulocyte antibodies enables assessment of metastases in the entire bone marrow.

Topics: Bone Marrow Neoplasms; Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Follow-Up Studies; Granulocytes; Humans; Immunoglobulin G; Middle Aged; Neoplasm Staging; Predictive Value of Tests; Radioimmunodetection; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Technetium Tc 99m Medronate

We report a case of metastatic breast cancer that showed extraosseous accumulation of 99mTc-HMDP in left axillary lymph nodes on bone scintigraphy. Our patient had a giant left breast mass and multiple lymph node metastases with atypical calcifications. It is known that breast cancer sometimes is positively visualized as extraosseous accumulation on bone scintigraphy. Accumulation to metastatic lymph nodes of breast cancer has rarely been reported. It is suggested that bone scintigraphy is of benefit in detecting the metastatic lymph nodes of breast cancer as a screening or follow-up method.

Topics: Axilla; Bone and Bones; Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Humans; Lymph Nodes; Lymphatic Metastasis; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Bone and Bones; Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Humans; Meningeal Neoplasms; Meningioma; Middle Aged; Neoplasms, Multiple Primary; Radionuclide Imaging; Technetium Tc 99m Medronate

Breast cancer in men is a rare disease, representing less than 1% of all breast cancers. Recently, scintimammography with 99mTc-methylene diphosphonate (MDP) has been proposed as an effective method in the differential diagnosis of breast masses. A 67-yr-old man with breast cancer that showed avid accumulation of 99mTc-MDP is presented in this article. Infiltrative ductal carcinoma was demonstrated histopathologically.

Topics: Aged; Breast Neoplasms, Male; Carcinoma, Ductal, Breast; Humans; Male; Radionuclide Imaging; Technetium Tc 99m Medronate

A patient with disseminated osseous metastases due to breast cancer reported multifocal pain. Because of persisting pain after a first cycle of chemotherapy, 1,295 MBq Re-186 HEDP was administered intravenously. Excellent pain relief was observed. Subsequently, the patient received further combined chemotherapy and Re-186 HEDP therapy and remained pain free. Tc-99m MDP bone imaging showed a significant regression of osseous metastases. It may be speculated that the combination of Re-186 HEDP and chemotherapy results in significantly increased palliation of metastatic bone disease.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Breast Neoplasms; Carcinoma, Ductal, Breast; Combined Modality Therapy; Etidronic Acid; Female; Humans; Middle Aged; Palliative Care; Radioisotopes; Radionuclide Imaging; Radiopharmaceuticals; Rhenium; Technetium Tc 99m Medronate

Focal soft-tissue accumulation of bone-seeking radiopharmaceuticals has many causes but is usually less intense than skeletal activity. Extraskeletal new bone formation, as seen in myositis ossificans and extraskeletal osteosarcoma, represents an exception where markedly increased uptake can be seen. Technetium-99m-MDP uptake in primary breast carcinoma has been recently investigated using scintamammographic techniques to differentiate malignant from benign lesions. The mechanism of uptake remains unclear but is likely multifactorial and nonspecific. We present a case of primary breast carcinoma with florid 99mTc-MDP activity relative to normal bone. Tumor histopathology in this patient demonstrates malignant new bone formation as the likely mechanism for the marked radiotracer avidity.

Topics: Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Humans; Metaplasia; Middle Aged; Ossification, Heterotopic; Radionuclide Imaging; Sarcoma; Technetium Tc 99m Medronate