The significance of bone scan abnormalities in patients with primary osteogenic sarcoma

The radionuclide bone scans and medical records of 62 patients with osteogenic sarcoma were reviewed to determine the significance of abnormalities demonstrated by the initial scintigraph at sites other than the primary lesion. 94% (58/62) of patients had abnormally increased tracer uptake at sites other than the primary tumor location. Eighty percent (49/62) of patients had abnormal bone scans at the ipsilateral proximal weight bearing joints. Only two of these patients later demonstrated metastatic tumor. Sixty-one percent (38/62) of patients had abnormal bone scans at joints distal to the primary tumor and none were due to tumor. Five patients ultimately developed osseous metastases at sites that were normal in the original scan. The majority of radionuclide bone scan abnormalities occurring at the time of diagnosis of osteogenic sarcoma at locations distant from the primary tumor site do not represent metastatic disease.