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Unusual persistence of Tc-99m MDP uptake in the incisional scar after thoracotomy
Abstract:
Postoperative scar is one of the causes of extraosseous localization of Tc-99m phosphonate bone agents. Usually, an incisional scar will not be visualized in a Tc-99m phosphonate skeletal image two weeks after surgery. A case is reported with an unusually persistent localization of radiotracer in the scar of a thoracotomy seen in three consecutive bone images done beyond two weeks postoperatively. This patient suffered from "pulmonary insufficiency" before and after the thoracotomy. The abnormal radiotracer localization in the scar is presumably related to his pulmonary insufficiency, with resulting relatively delayed wound healing.
Insights
Postoperative scars can show up on bone scans. In a unique case, a thoracotomy scar remained visible on technetium-99m phosphonate bone imaging for over two weeks, likely due to delayed healing from pulmonary insufficiency.
Area of Science:
- Nuclear Medicine
- Radiopharmacology
- Surgical Imaging
Background:
- Bone scintigraphy using technetium-99m phosphonate agents is a standard diagnostic tool.
- Postoperative scars typically show transient radiotracer uptake, resolving within two weeks.
- Extraosseous localization of bone agents can occur in various soft tissues.
Observation:
- A case study involving a patient who underwent thoracotomy.
- Persistent visualization of the surgical scar on serial bone scintigraphy beyond the expected two-week timeframe.
- The patient had a history of pulmonary insufficiency pre- and post-surgery.
Findings:
- Unusually prolonged Tc-99m phosphonate uptake in a thoracotomy scar.
- Abnormal radiotracer localization persisted across three bone imaging studies.
- The findings suggest a link between the patient's pulmonary insufficiency and delayed scar healing.
Implications:
- Pulmonary insufficiency may contribute to delayed wound healing and prolonged radiotracer uptake in surgical scars.
- This case highlights the importance of considering patient comorbidities in interpreting bone scan findings.
- Further investigation into the mechanisms of delayed healing in specific patient populations is warranted.