Diffuse Pulmonary 99mTc-MDP Uptake on Bone Scintigraphy: A Paraneoplastic Hypercalcemia Clue in Cervical Carcinoma

<sup>99m</sup>Tc-methylene diphosphonate bone scintigraphy is a cornerstone imaging modality for skeletal assessment; however, extraosseous radiotracer uptake may signal underlying systemic metabolic derangements. Diffuse pulmonary uptake, classically linked to metastatic calcification, is commonly observed in chronic kidney disease patients with calcium-phosphate homeostasis disruption. We present an uncommon case of bilateral pulmonary <sup>99m</sup>Tc-Methylene diphosphonate (MDP) uptake in a 48-year-old female with advanced cervical carcinoma, renal insufficiency, and severe hypercalcemia accompanied by paradoxically normal parathyroid hormone levels. While thoracic computed tomography showed no structural abnormalities, bone scintigraphy demonstrated diffuse pulmonary radiotracer accumulation, consistent with metastatic calcification secondary to calcium-phosphate deposition within alveolar walls. This case underscores the critical need for vigilant monitoring of metabolic complications in oncology patients, especially those with renal impairment, and highlights the diagnostic value of bone scintigraphy in identifying occult extraskeletal pathologies, even when conventional imaging appears unremarkable. The findings advocate for integrating metabolic profiling with functional imaging to better understand atypical tracer uptake patterns in high-risk populations.

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Journal
Indian Journal of Nuclear Medicine
Published
2025-03-01
DOI
https://doi.org/10.4103/ijnm.ijnm_19_25
Primary Topic
Medical Imaging and Pathology Studies
Type
article
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article

Diffuse Pulmonary 99mTc-MDP Uptake on Bone Scintigraphy: A Paraneoplastic Hypercalcemia Clue in Cervical Carcinoma

Salah Nabih Oueriagli, Omar Ait Sahel, Abderrahim Doudouh, Yassir Benameur et al.
Indian Journal of Nuclear Medicine
Medical Imaging and Pathology Studies
article

Diffuse Pulmonary 99mTc-MDP Uptake on Bone Scintigraphy: A Paraneoplastic Hypercalcemia Clue in Cervical Carcinoma

Salah Nabih Oueriagli, Omar Ait Sahel, Abderrahim Doudouh, Yassir Benameur, Meryem Aboussabr, Ikram Zahfir
article en

Abstract

<sup>99m</sup>Tc-methylene diphosphonate bone scintigraphy is a cornerstone imaging modality for skeletal assessment; however, extraosseous radiotracer uptake may signal underlying systemic metabolic derangements. Diffuse pulmonary uptake, classically linked to metastatic calcification, is commonly observed in chronic kidney disease patients with calcium-phosphate homeostasis disruption. We present an uncommon case of bilateral pulmonary <sup>99m</sup>Tc-Methylene diphosphonate (MDP) uptake in a 48-year-old female with advanced cervical carcinoma, renal insufficiency, and severe hypercalcemia accompanied by paradoxically normal parathyroid hormone levels. While thoracic computed tomography showed no structural abnormalities, bone scintigraphy demonstrated diffuse pulmonary radiotracer accumulation, consistent with metastatic calcification secondary to calcium-phosphate deposition within alveolar walls. This case underscores the critical need for vigilant monitoring of metabolic complications in oncology patients, especially those with renal impairment, and highlights the diagnostic value of bone scintigraphy in identifying occult extraskeletal pathologies, even when conventional imaging appears unremarkable. The findings advocate for integrating metabolic profiling with functional imaging to better understand atypical tracer uptake patterns in high-risk populations.

Indian Journal of Nuclear MedicineVol. 40(2)
Mohammed V University (MA)
Good health and well-being
Openalex Percentile: Top 75%
Medical Imaging and Pathology Studies
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