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Postgastrectomy osteomalacia with pseudofractures assessed by repeated bone scintigraphy
1Department of Radiology, Toyama Medical and Pharmaceutical University, Japan.
Annals of Nuclear Medicine
|February 1, 1995
Summary
This case highlights how vitamin D deficiency osteomalacia can mimic bone metastases on initial scans. Repeated bone scintigraphy after vitamin D treatment confirmed osteomalacia, not cancer spread.
Area of Science:
- Nuclear Medicine
- Radiology
- Endocrinology
Background:
- Gastric cancer surgery can lead to malabsorption and vitamin D deficiency.
- Vitamin D deficiency can cause osteomalacia, a bone disorder characterized by impaired mineralization.
Observation:
- A patient post-gastrectomy presented with bone scintigraphy findings mimicking bone metastases.
- These findings included asymmetric and symmetric focal intense uptake due to pseudofractures.
- Radiographs confirmed pseudofractures but not at all scintigraphic sites.
Findings:
- Initial suspicion of metastatic bone disease was high.
- Repeated bone scintigraphy normalized after vitamin D treatment.
- This confirmed a diagnosis of osteomalacia secondary to vitamin D deficiency.
Implications:
- Symmetric focal lesions on bone scintigraphy can indicate pseudofractures in osteomalacia.
- Distinguishing osteomalacia pseudofractures from bone metastases requires comparison with radiographs and serial bone scintigraphy.
- This case emphasizes the importance of considering metabolic bone disease in patients with prior gastric surgery.