Symmetrical bone scan in a patient with acute hypercalcemia

Area of Science:

• Oncology
• Hematology
• Radiology

Background:

• Hypercalcemia can present with diverse etiologies, necessitating thorough investigation.
• Parathyroid hormone-independent hypercalcemia requires evaluation for other underlying causes, including malignancy.

Observation:

• A previously healthy 49-year-old woman presented with acute hypercalcemia.
• Bone scintigraphy revealed increased juxtaarticular uptake in multiple joints.
• Skeletal lesions were identified on roentgenograms.

Findings:

• Biopsy confirmed skeletal lesions consistent with multiple myeloma.
• The patient had no clinical signs or symptoms of arthritis.
• Symmetrical bone scan findings in conjunction with hypercalcemia suggested an underlying hematologic malignancy.

Implications:

• Symmetrical bone scan findings in asymptomatic joints coupled with hypercalcemia may represent an early indicator of multiple myeloma.
• This case highlights the importance of considering hematologic malignancies in patients with unexplained hypercalcemia and specific bone scan patterns.
• Prompt diagnosis of multiple myeloma is essential for effective management and improved patient outcomes.