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Unusual bilateral Tc-99m DPD uptake on bone scan
Stefan Merk1, Michael Hentschel, Jochen Talazko
1Department of Nuclear Medicine, University Hospital Freiburg, Germany. smerk@ukl.uni-freiburg.de
Clinical Nuclear Medicine
|October 28, 2003
Summary
Bone scan revealed unusual skull lesions in a prostate cancer patient after subdural hematoma treatment. These "devil-like" findings suggest increased bone metabolism in the trepanation sites.
Area of Science:
- Radiology
- Oncology
- Neurosurgery
Background:
- Prostate cancer screening for bone metastases is standard practice.
- Subdural hematoma is a known complication, requiring surgical intervention like craniotomy.
- Bilateral trepanation is a rare neurosurgical procedure.
Observation:
- A 74-year-old man with prostate cancer presented for bone metastasis screening.
- Imaging showed severe degenerative skeletal changes but no metastases.
- Unexpected bilateral, symmetric "devil-like" lesions were observed in the skull frontolateral regions.
Findings:
- The patient had undergone bilateral borehole trepanation for a subdural hematoma three weeks prior.
- The skull lesions were interpreted as areas of augmented bone metabolism.
- No bone metastases were detected, ruling out cancer spread to the bone.
Implications:
- This case highlights potential imaging findings following rare neurosurgical procedures.
- It emphasizes the importance of correlating imaging findings with patient history.
- The "devil-like" lesions serve as a unique imaging biomarker for localized bone remodeling post-trepanation.