Incidental metastatic breast cancer (Tc99m-sestamibi parathyroid scan)
Presentation
Presentation with hypercalcemia detected on routine blood. Scan for ? parathyroid adenoma.
Patient Data
Tc-99m sestamibi scan
Abnormal accumulation of isotope in the left anterior chest wall (patchy) and also within the right lung (rouned).
On the basis of the T...
On the basis of the Tc99m-sestamibi findings CT was undertaken
Large lobulated mass in the left breast consistent with advanced cancer. Rounded lung metastases and large lytic bone metastasis in the left ilium no doubt responsible for the hypercalcemia.
Case Discussion
Tc99m-sestamibi is a radiopharmaceutical that is taken up by cells with a high concentration of mitochondria, i.e. highly cellular/metabolically active tissues such as the heart but also abnormal tissues such as oxyphil cell parathyroid adenomas, myeloma and breast cancer (the basis of so-called scintimammography). This latter technique has a high specificity for cancer but uses significant radiation dose. In this case, a scan for hyperparathyroidism has shown up a breast cancer with metastases (also accumulating sestamibi) explaining the hypercalcemia.
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