Paget's disease mimicing skeletal metastases in a patient with coexisting prostatic carcinoma

We present a 93-year-old man with prostatic carcinoma whose 99mTc-HMDP skeletal images showed multiple areas of abnormally increased radioactivity in the bone and virtual absence of renal activity. These findings were interpreted as representing multiple skeletal metastases. When correlated with concurrent radiographs, the abnormalities were found to be due to Paget's disease. Multiple areas of bone involvement are not rare in Paget's disease. We reemphasize that an abnormal bone scintigram should always be correlated with regional radiographs to rule out conditions other than malignancy.