Breast cancer skeletal metastases

Case contributed by Dr Sally Ayesa

Presentation

Lower back pain

Patient Data

Age: 65 years
Gender: Female
Nuclear medicine

Delayed planar whole body planar and spot views demonstrate multiple foci of increased tracer accumulation in the axial and proximal appendicular skeleton. Lesions are most numerous in the pelvis, with the most intense lesions seen in bilateral posterior iliac bones and the left iliac crest. 

Case Discussion

This is a case of osteoblastic metastatic disease in a patient with known breast cancer. Osteoblastic skeletal metastases demonstrate increased uptake of tracer (Tc99m HDP or MDP), reflecting the increased rate of matrix deposition associated with the lesions. On bone scan, skeletal metastases are more common in the axial and proximal appendicular skeleton. 

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