Tarsarya Sunita, Marwah Atul, Shah Hardik, Jaiswar Rajnath
Department of Nuclear Medicine and PET, Bombay Hospital and Medical Research Centre, Mumbai, India.
Indian J Nucl Med. 2012 Jul;27(3):205-7. doi: 10.4103/0972-3919.112746.
A 55-year-old female presented with complaints of pain in the left hip radiating to the left lower limb since 1 year. Computed tomography (CT) abdomen and pelvis revealed bony destruction of pubic symphysis with associated soft tissue component suspicious of infective or metastatic etiology. Magnetic resonance imaging Lumbo-sacral spine performed later revealed altered bone marrow signal in sacral 1-3 vertebrae. Wholebody bone scan with 25 mCi of Tc-99m methylene diphosphonate (MDP) was performed, which revealed multiple skeletal metastases and extraosseous soft tissue uptake was seen involving multiple muscles. We performed single photon emission tomography single photon emission computed tomography (SPECT)/computed tomography (CT) images to precisely delineate the muscle involved and noted calcification on CT images in one of the muscle at site of Tc-99m MDP uptake, no definite calcification was noted in the other muscles. Thus, the final diagnosis was multiple skeletal metastasis with metastatic calcification in multiple muscle from an unknown primary.
一名55岁女性自1年前起出现左髋部疼痛并向左下肢放射的症状。腹部和骨盆计算机断层扫描（CT）显示耻骨联合骨质破坏，并伴有可疑感染或转移病因的软组织成分。随后进行的腰骶椎磁共振成像显示骶1至3椎体骨髓信号改变。进行了25毫居里锝-99m亚甲基二膦酸盐（MDP）全身骨扫描，结果显示多处骨骼转移，且在多处肌肉可见骨外软组织摄取。我们进行了单光子发射断层扫描/计算机断层扫描（SPECT/CT）图像检查，以精确描绘受累肌肉，并注意到在锝-99m MDP摄取部位的一块肌肉的CT图像上有钙化，其他肌肉未发现明确钙化。因此，最终诊断为不明原发灶的多处骨骼转移伴多处肌肉转移性钙化。
