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

A 47-year-old woman with adenocarcinoma of the right breast had bone scintigraphy with Tc-99m MDP. Bone imaging did not show any metastases. However, a large area of increased tracer uptake was seen extending from the abdomen to the pelvis. Abdominal ultrasound revealed a large solid and heterogeneous mass, measuring 18 x 11 x 14.3 cm, that originated in an empty uterus. A biopsy of the surgical specimen showed a leiomyoma of the uterus.

Topics: Adenocarcinoma; Biopsy; Breast Neoplasms; Female; Humans; Leiomyoma; Middle Aged; Neoplasms, Multiple Primary; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Ultrasonography; Uterine Neoplasms

Topics: Adult; Bone Neoplasms; Breast Neoplasms; Diagnosis, Differential; Female; Humans; Leiomyoma; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Urinary Bladder; Uterine Neoplasms

Topics: Bone and Bones; Bone Neoplasms; Carcinoma; Diaphragm; Female; Humans; Middle Aged; Pelvis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Uterine Neoplasms

99mTc-methylene diphosphonate (99mTc-MDP) bone scans in 80 patients, 30-80 years old (average, 62 years old) with uterine cancer who received high doses of radiation (10-60 Gy; average, 46 Gy) were reviewed retrospectively to evaluate the frequency of pelvic insufficiency fractures caused by radiotherapy and to study the appearance of the fractures on bone scans. Bone scans in 29 of 80 patients showed abnormalities in the pelvis: insufficiency fractures were identified in 27 patients (34%) and osseous metastases were found in two patients (3%). The fractures and metastases were diagnosed by CT and were confirmed by observing the patients' clinical courses. Fractures were identified in 27 (39%) of 69 postmenopausal women and in none of 11 premenopausal patients (p greater than .05). Fractures were found in 21 (84%) of 25 patients who had pelvic pain and in six (11%) of 55 patients who were asymptomatic (p greater than .001). Scintigrams in patients with fractures showed more than one fracture in most patients (85%), and fractures were often symmetric (67%). Scintigrams in two patients with osseous metastases showed increased activity in an iliac wing that was outside the radiation field. Our results suggest that a marked increase in insufficiency fractures occurs after radiation therapy, especially in postmenopausal patients. A symmetric area of increased uptake of radionuclide is a characteristic scintigraphic appearance of an insufficiency fracture.

Topics: Adult; Aged; Female; Fractures, Bone; Fractures, Spontaneous; Humans; Middle Aged; Pelvic Bones; Radiography; Radionuclide Imaging; Radiotherapy; Technetium Tc 99m Medronate; Uterine Neoplasms

Topics: Aged; Aged, 80 and over; Diagnostic Imaging; Female; Humans; Leiomyoma; Technetium Tc 99m Medronate; Uterine Neoplasms

Bone imaging is commonly used as a sensitive indicator of metastatic bone diseases or other bone pathology. Furthermore, it is now generally known that technetium-99m (99mTc) phosphonates tend to concentrate in various tissues other than bones. Ultrasonography is also widely used for the evaluation of pelvic masses. Ultrasonography is especially useful for detecting a cystic mass. We present a case where the uptake of 99mTc phosphonate compounds occurred in the entire abdomen, and ultrasonography suggested a diagnosis of pseudomyxoma peritonei, but the condition was later proven to be degeneration of giant subserous leiomyoma of the uterus. We have found two interesting features in this case. One is the 99mTc phosphonate concentration in the large cystic and hyaline degeneration of subserous leiomyoma of the uterus without calcification, and the other is the sonographic finding of a large echogenic mass with innumerable small anechoic areas. To our knowledge, no cases of 99mTc phosphonate concentration in non-calcified leiomyoma of the uterus have been demonstrated.

Topics: Adult; Female; Humans; Leiomyoma; Radionuclide Imaging; Technetium Tc 99m Medronate; Ultrasonography; Uterine Neoplasms

Examination for liver and bone metastases was performed in 30 women suffering from carcinoma of the uterus and in 27 with cervical and 37 with ovarian carcinoma. Scintigraphy was the examination method of choice in bone metastases and computed tomography in liver metastases. Bone metastases were not seen in any patient in the stages I to IV with carcinoma of the cervix and ovarian carcinoma. Bone metastases were found in one patient in stage III and in one in stage IV with carcinoma of the uterus. Liver metastases were found in four patients in stages III and IV with carcinoma of the uterus and in five patients with ovarian carcinoma.

Topics: Bone Neoplasms; Female; Humans; Liver Neoplasms; Middle Aged; Neoplasm Staging; Ovarian Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Uterine Cervical Neoplasms; Uterine Neoplasms

Topics: Aged; Calcinosis; Female; Humans; Leiomyoma; Radionuclide Imaging; Technetium Tc 99m Medronate; Uterine Neoplasms

Staging bone scans or skeletal surveys were obtained of 97 patients with endometrial carcinoma. Of the 77 patients with Stage I or II disease, no metastases were identified at staging. Three patients in the entire series demonstrated bony metastases; all of these metastases were detectable by radionuclide bone scan and radiographic bone survey. Eighty-nine patients were examined with radionuclide liver/spleen scanning at the time of staging. Four of the 89 initial scans were interpreted as demonstrating hepatocellular disease, and all four patients had abnormal liver function studies. Only one patient demonstrated a possible hepatic metastasis at initial diagnosis. This patient also had abnormal liver function studies. Based on these results, bone surveys and radionuclide bone scans are not indicated as screening procedures in endometrial carcinoma. It is suggested that screening for liver metastases in patients with endometrial carcinoma is not warranted in patients with normal liver function studies.

Topics: Bone Neoplasms; Carcinoma; Diphosphates; Diphosphonates; Female; Humans; Liver Neoplasms; Neoplasm Staging; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Uterine Neoplasms