Activity Within an Extraperitoneal Ureteral Herniation Detected on Bone Scan, Associated With a Partially Duplicated...

Area of Science:

• Urology
• Radiology
• Medical Imaging

Background:

• Prostate cancer management involves monitoring for osseous metastases.
• Bone scans are crucial for detecting skeletal involvement.
• Unusual presentations can complicate diagnostic interpretation.

Observation:

• A 64-year-old man with prostate cancer showed unusual linear uptake on a Tc-labeled bone scan in the lower pelvis extending to the scrotum.
• Computed tomography (CT) revealed an uncommon inguinoscrotal extraperitoneal herniation of the ureter.

Findings:

• The bone scan uptake corresponded to the herniated ureter, not metastatic disease.
• The patient had a partially duplicated left renal collecting system.
• This rare anatomical variation can mimic pelvic pathology on nuclear imaging.

Implications:

• Accurate diagnosis of genitourinary abnormalities requires correlation of nuclear medicine and cross-sectional imaging.
• Awareness of rare ureteral herniation is essential for radiologists and urologists.
• This case underscores the need for comprehensive evaluation to avoid misdiagnosis of metastatic cancer.