Hepatic metastasis arising from diverse primary pathologies diagnosed on 99mTc-Methylene diphosphonate bone scan

Abstract

We are presenting two cases that illustrate nonosseous localization of 99mTc-Methylene diphosphonate (MDP) in hepatic metastases arising from varied primary pathology and review of the literature. This series emphasizes the evidence of MDP localization in hepatic metastases arising from adenocarcinoma of rectum and infiltrating duct cell carcinoma of the breast.

The Intricate Diagnostic Journey of a Breast Cancer Patient, Revealing Extensive Hepatic Metastasis Through Extraosseous Uptake in Planar Bone Scintigraphy and SPECT-CT Precision Mapping

“…In cases of hepatic metastases, the pattern of MDP uptake typically appears focal and scattered rather than diffuse. This distinction may be attributed to calcifications or cellular necrosis within the metastatic lesions (3,4). The similar pattern is observed in our presenting case, and we confirmed it through SPECT/CT.…”

“…The differentiation between benign and pathological conditions is based on the degree and pattern of uptake. Artefactual or faulty preparation of radiopharmaceuticals, such as excess aluminum ion breakthrough in 99mTc eluate, misadministration, or extravasation from the injection site, may manifest as mild diffuse hepatic uptake (2,3). Pathological causes, such as diffuse hepatic necrosis, repeated iron injections, acute hypoxic hepatitis, hypoxia secondary to respiratory failure, amyloidosis associated with plasma cell dyscrasia, and the late stage of multiple myeloma, can exhibit diffuse and intense hepatic MDP uptake.…”