Serendipitous Ureteral Stone Revealed on 99mTc-MDP Bone Scintigraphy

Area of Science:

• Nuclear medicine imaging
• Urologic diagnostics
• Oncologic staging

Background:

• Bone scintigraphy using Technetium Tc-99m medronate (Tc-MDP) is a standard imaging modality for detecting bone metastases in cancer patients.
• Esophageal cancer staging often involves bone scans to rule out skeletal involvement.

Observation:

• A 62-year-old male patient with esophageal cancer underwent Tc-MDP bone scintigraphy for staging.
• Incidental focal areas of increased radiotracer uptake were noted in the pelvic region.
• SPECT/CT imaging was performed for further characterization of these findings.

Findings:

• The bone scintigraphy revealed no evidence of bone metastases.
• SPECT/CT confirmed the focal increased activity in the left pelvis represented a ureteral stone.
• The finding was incidental to the primary indication for the bone scan.

Implications:

• Bone scintigraphy can incidentally detect non-skeletal pathology, such as ureteral calculi.
• This case underscores the importance of careful image review beyond the primary diagnostic question.
• Nuclear medicine imaging may offer additional diagnostic value in unexpected findings during oncologic staging.