Super Scan Prostate Carcinoma (Prepared by Dr Isabel Berrocal).
A B
A: 64 year old male patient, known hypertensive, under prostate cancer staging, in right hip pain with no history of fractures or bone surgery. Diffusely increased activity in all bones, especially axial and apendicular skeleton, with minimal activity in the kidneys is suggestive of "super scan". B: For comparison in the right side, 81 year old male, operated on prostatic carcinoma some years ago, complaining of right shoulder pain, PSA was 55.1 ng/ml. Many foci of marked increased MDP uptake mainly in axial and apendicular (humerus) skeleton with irregular distribution.
Causes of Super Scan:
Nonmalignant conditions: Hyperparathyroidism, Renal Osteodystrophy, Osteomalacia, Hyperthyroidism, Acromegaly, Hypervitaminosis D, Mastocytosis.
Malignant disorders: Metastatic Prostate carcinoma, Breast carcinoma, Lung carcinoma, Transitional cell carcinoma, Colon carcinoma, Lymphoma, Agnogenic myeloid metaplasia (myelofibrosis).
References:
1) Mehrzad C., et al. Diffuse Increased Uptake on Bone Scan: Super Scan Seminars in Nuclear Medicine, Vol XXXIV, No 2 (April), 2004: 154-156.
2)
Kanazawa K., Isozaki E. "Super Bone Scan" in a Case of Diffuse Bone Marrow Metastasis of Gastric Adenocarcinoma, Inter Med 48: 1719-1720, 2009.