An Incidental Detection of Breast Cancer Osteolytic Bone Metastasis Using a 99m Tc-TRODAT-1 SPECT Scan
Chun-Liang Kuo1, Yu-Hong Chang, Rong-Hsin Yang
1From the Department of Nuclear Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan.
Clinical Nuclear Medicine
|August 28, 2024
Summary
This case report details a 76-year-old woman with suspected Parkinson disease. Unexpectedly, SPECT scans revealed bone metastasis from breast cancer, not solely neurodegeneration.
Area of Science:
- Neurology
- Nuclear Medicine
- Oncology
Background:
- Parkinson disease diagnosis can be complex, especially in older adults presenting with motor symptoms like bradykinesia and gait instability.
- Dopamine transporter imaging using 99m Tc-TRODAT-1 SPECT is a tool used to evaluate nigrostriatal integrity.
Observation:
- A 76-year-old woman presented with symptoms suggestive of Parkinson disease.
- 99m Tc-TRODAT-1 SPECT imaging showed symmetrically decreased bilateral nigrostriatal system uptake.
- Increased uptake of 99m Tc-TRODAT-1 in bilateral frontal and left temporal bones was noted.
Findings:
- The SPECT findings of decreased nigrostriatal uptake could indicate normal aging or atypical parkinsonism.
- Review of bone scan and CT images revealed osteolytic lesions corresponding to the areas of increased uptake.
- These lesions were indicative of bone metastasis from breast cancer.
Implications:
- This case highlights the importance of considering non-neurological pathologies when interpreting neuroimaging findings.
- It underscores the need for comprehensive diagnostic workups to differentiate between neurodegenerative diseases and metastatic disease.
- Integrated imaging approaches are crucial for accurate diagnosis and patient management.
