Open AccessLaxative related primary hyperphosphatemic tumoral calcinosis identified by bone scintigraphy
Author(s) -
Marcus Asokendaran,
Nat Lenzo
Publication year - 2016
Publication title -
world journal of nuclear medicine
Language(s) - Uncategorized
Resource type - Journals
eISSN - 1607-3312
pISSN - 1450-1147
DOI - 10.4103/1450-1147.174709
Subject(s) - medicine , tumoral calcinosis , bone scintigraphy , calcinosis , radiology , calcification , malignancy , diphosphonates , scintigraphy , metastatic calcification , lung , nuclear medicine , pathology , bone resorption
We describe a case of a 40-year-old female patient presenting with tumor calcinosis where hypertrophic pulmonary osteoarthropathy (HPOA) was suspected given her extensive history of malignancy. Plain X-rays did not show reveal the typical periarticular calcification but did show appearances consistent with HPOA. Bone scintigraphy with (99m)Tc-methylene diphosphonate (MDP) is a sensitive investigation in the detection of hypertrophic osteoarthopathy but did not show findings characteristics of HPOA like bilateral symmetrical increased uptake of the radiopharmaceutical along the cortical margins of the long bones. The final diagnosis of tumor calcinosis was only made after low dose computerized tomography chest showed a moderated sized amorphous calcified cluster in the apical segment of the right upper lobe consistent. In conclusion, bone scintigraphy continues to be a useful investigation for both common and rare conditions like tumor calcinosis. The unusual three phase bone scan finding of diffuse activity throughout both lung fields, which turned to out to be tumoral calcinosis is highlighted in this case.