technetium-tc-99m-medronate and Tuberous-Sclerosis

We report a 15-year-old patient with tuberous sclerosis complex or Bourneville's disease with history of generalized tonic-clonic seizure for last 2 years and was currently on antiepileptic medication. He also had a history of left nephrectomy for renal cell carcinoma clear cell type. The patient had multiple adenoma sebaceum over the nasolabial region, ash leaf spots over the lower limbs, a Shagreen patch over the back, and multiple calcified tubers in the subependymal region. He was then referred for the skeletal scintigraphy to look for skeletal lesions, which revealed involvement of bilateral humeri, tibiae, and iliac bones accurately characterized on SPECT/CT.

Topics: Adolescent; Bone and Bones; Humans; Male; Multimodal Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Tuberous Sclerosis

Whole-body Tc-99m HDP scintigraphy was performed in a 25-year-old woman with known tuberous sclerosis. The scintigraphic pattern showed multiple foci of abnormal activity over the hands, phalanges, feet, tibias, fibulas, ulnas, and radii, where radiographs showed periosteal apposition, irregular cortical thickening, and cystlike lesions on the phalanges. The spine, pelvis, and ribs showed heterogeneous tracer uptake where radiographs showed patchy areas of increased bone density. This radiographic pattern is characteristic of osseous tuberous sclerosis. Although previous reports suggested the opposite conclusion, this observation indicates that an abnormal result of bone scintiscan can be observed in osseous tuberous sclerosis.

Topics: Adult; Bone and Bones; Female; Humans; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tuberous Sclerosis