technetium-tc-99m-medronate and Testicular-Neoplasms

Bone scintigraphy is very sensitive in detecting metastases in an early stage, when changes in osteoblast function precede morphologic changes. In many oncologic situations, however, osteoarticular abnormal changes seen on the bone scan are not caused by tumor infiltration. They may be due to tumor associated conditions, such as carcinoma polyarthritis and hypertrophic pulmonary osteoarthropathy. They also may be due to therapy-associated conditions, such as the flare effect on metastases due to hormonal treatment, chemotherapy or radiotherapy, and osteonecrosis as a complication of radiotherapy or the use of corticosteroids. The introduction of Colony Stimulating Factors (CSF) to reduce myelotoxicity have allowed higher doses of chemotherapeutic agents to be administered. Currently, there is research being performed on the clinical effects of CSF in phase-II studies. In addition to the flare response of metastases, increased uptake in the axial skeleton and/or juxta-articular areas on bone scintigraphy in five patients receiving CSF has been observed. This new phenomenon could be explained by a reaction to a very cellular marrow caused by the use of CSF. The clinical relevance of this finding remains to be established. The authors present an overview of these old and new phenomena seen on the bone scan with clinical and roentgenologic correlation.

Topics: Adult; Aged; Bone and Bones; Breast Neoplasms; Female; Granulocyte Colony-Stimulating Factor; Humans; Iatrogenic Disease; Male; Middle Aged; Neoplasms; Paraneoplastic Syndromes; Radionuclide Imaging; Rhabdomyosarcoma; Technetium Tc 99m Medronate; Teratoma; Testicular Neoplasms

Testicular tumors do not occur frequently. Primary treatment is surgical, and radiotherapy and chemotherapy can play important roles in cases of metastatic disease. Bone scintigraphy is used largely for early detection of skeletal metastases from several tumors, and conventional radiographic studies are less sensitive than the nuclear technique for such a purpose. The aim of this study was to identify the role of bone scintigraphy in cases of testicular tumors, regardless of the grade.. The authors examined 28 patients (8 to 52 years old) with proved testicular tumors using Tc-99m MDP (750 MBq; 20 mCi) injected intravenously. Whole-body images were obtained 2 hours later, at 500,000 counts per image. Radiographic studies were obtained to investigate abnormal areas noted on scintigraphy.. The results of bone scintigraphy were abnormal in seven cases, consisting of variable but diffuse uptake in the iliac bone on the same side as the affected testicle. MDP uptake was substantial in five of these patients (four seminomas, one nonseminoma; only two radiographic studies were abnormal), and the two other patients had moderate uptake of the radiopharmaceutical (two seminomas; radiographic studies were normal). Metastases were confirmed by biopsy in three cases.. Early metastases from seminomas can occur through the lymphatic drainage toward the iliac lymph node chain. This could explain these findings. The scintigraphic aspects of the affected iliac bones seem characteristic.. Early detection of metastases is very important to ensure the efficacy of radiotherapy and chemotherapy. Bone scintigraphy may play an important role in such cases and seems to be more sensitive than conventional radiography. Testicular tumor metastases should be considered when iliac involvement is observed. Paget's disease should be included in a differential diagnosis.

Topics: Adolescent; Adult; Bone and Bones; Bone Neoplasms; Child; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Seminoma; Technetium Tc 99m Medronate; Testicular Neoplasms

An 83-year-old man with testicular lymphoma demonstrated progressive scrotal enlargement with non-homogeneity sonographically and abnormally increased uptake in the scrotum of Tc-99m HMDP and Tc-99m MIBI scintigraphically. Extensive bone/bone marrow metastases were exhibited by Tc-99m MIBI and Tc-99m HMDP scintigraphies and MRI of the spine. In addition, focal/tubular activity of the femoral bone marrow on Tc-99m MIBI imaging was consistent with skeletal scintigraphic findings. It is emphasized that Tc-99m MIBI total body imaging enabled the demonstration of testicular lymphoma as increased uptake and the illustration of skeletal/bone marrow metastases as diffuse and/or focal increased uptake, especially focal/tubular MIBI activity of the femoral marrow.

Topics: Aged; Bone Marrow Neoplasms; Bone Neoplasms; Humans; Lymphoma, B-Cell; Magnetic Resonance Imaging; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Testicular Neoplasms; Ultrasonography

Topics: Adult; Bone and Bones; Cartilage; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Scrotum; Technetium Tc 99m Medronate; Teratoma; Testicular Neoplasms

Topics: Adult; Diagnosis, Differential; Dysgerminoma; Humans; Kidney; Kidney Neoplasms; Male; Radionuclide Imaging; Retroperitoneal Neoplasms; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Teratoma; Testicular Neoplasms

Topics: Abdomen; Adenocarcinoma; Adult; Aged; Ascitic Fluid; Diphosphonates; Female; Humans; Leukemia, Myeloid; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; Ovarian Neoplasms; Radionuclide Imaging; Stomach Neoplasms; Technetium; Technetium Tc 99m Medronate; Teratoma; Testicular Neoplasms; Urethral Neoplasms