Transient accumulation of Tc 99m MDP in the liver

A patient with multiple myeloma complicated by hypercalcemia is presented. During the state of an elevated calcium phosphate product a transient diffuse accumulation of Tc 99m MDP in the liver was demonstrable, whereas the demonstrated metastatic calcifications of the kidneys persisted after therapeutic reduction of the elevated ion product. This points to a difference in the formation of calcium phosphate precipitations in these organs. Accumulation of Tc 99m labelled bone seeking agents in the liver must not always mean severe liver damage or amyloidosis or tumour manifestation. An altered serum calcium phosphate balance has to be taken into account when interpreting scintigrams performed with bone seeking radiopharmaceuticals.