Bone Scan with Confusing Appearance: Superscan or Metabolic Disorder

摘要

We present a patient with metastatic prostate cancer with known bone involvement and unknownosteomyelofibrosis. It has the general appearance of a superscan, with homogeneously increased tracer uptake and novisualization of the kidneys. However, while a superscan should have greater uptake in the axial skeleton compared to theappendicular skeleton, this scan is reverse, raising the suspicion of an overlying metabolic bone disorder. Subsequentlaboratory-, bioptical findings confirmed a myeloproliferative syndrome with osteomyelofibrosis. As such, this scandemonstrates that in a patient with both affiliations, metabolic bone disease can override even severe osseous metastaseson a bone scan.