Tc-99m DMSA Uptake by Metastatic Colorectal Carcinoma

Colonic Visualization of 99mTc-DMSA Due to Enterovesical Fistula

A 60-year-old woman with recurrent urinary tract infection who had several operations for colorectal carcinoma underwent Tc-DMSA renal scintigraphy which showed an unexpected accumulation of radiotracer in the colon. When symptoms were reviewed, we noticed that she was suffering from pneumaturia and fecaluria which raised the suspicion of enterovesical fistula. Rectal contrast-enhanced computer tomography of pelvis demonstrated enterovesical and enterovaginal fistulas. Colonic radioactivity was considered to be related to retrograde peristalsis of Tc-DMSA from bladder activity via enterovesical fistula. In patients with pelvic surgeries and radiotherapy, radioactivity in the colon should raise the suspicion of enterovesical fistula.

Focal 99mTc-DMSA Uptake in Lung Parenchyma Without Structural Alterations on SPECT/CT

Static renal scintigraphy with Tc-DMSA is commonly used for the evaluation of renal morphology and function. Extrarenal uptake of Tc-DMSA is a rare finding described previously on sites such as bone metastasis, hemangioma, and splenic amyloidosis. We report a case with Tc-DMSA activity in the lungs.

Bone metastasis from colon carcinoma in an 11-year-old boy: radiological features and brief review of the literature

We report the case of an 11-year-old boy who came to our observation with localized pain in the left arm for nearly 5 months. No previous history of trauma was referred in an otherwise healthy patient. Radiographs, isotope bone-scan, computed tomography, and magnetic resonance imaging of the lesion involving the left humerus are discussed. Histological diagnosis from biopsy of the humerus was metastasis from mucinous adenocarcinoma. The primary tumor site was identified in the sigmoid-descending colon, and at presentation, in addition to the left humerus, the disease had already developed in multiple skeletal sites. This report also considers literature concerning such a rare disease in children. This is, to our knowledge, the first report of childhood colorectal cancer diagnosed because of a bone metastasis.

Hepatic and pulmonary nodular lesions in pediatric urinary tract infections

One of the major goals in investigating children with urinary tract infection (UTI) is to recognize patients at risk of further UTI-related problems. This study reports the clinical features of 19 pediatric patients with UTIs in whom associated hepatic and/or pulmonary nodules were incidentally diagnosed by the imaging tests performed for the UTI. Hepatic nodules in five patients were detected on ultrasound scans, and pulmonary nodules and both hepatic and pulmonary nodules were detected in 12 and two children by dimercaptosuccinic acid scintigraphy. The mean age of the patients was 24.5 months. Vesicoureteral reflux (VUR) was detected in nine of 17 patients (52.9%), acute pyelonephritis was identified in nine of 18 patients, and renal scarring was found in 57.1% patients with pyelonephritis. On follow-up, the hepatic and/or pulmonary nodules regressed in all patients. About 85.7% of patients experienced a recurrence of UTI within 1 year. In comparison with age- and sex-matched controls with UTIs without pulmonary or hepatic nodules, the presence of VUR and the recurrence of UTI within 1 year were higher in patients with UTIs and nodules (P<0.05). The hepatic and/or pulmonary nodules identified on the ultrasound scan and by dimercaptosuccinic acid scintigraphy may provide a valuable diagnostic marker for the proper management of patients with an UTI.

Incidental DTPA and DMSA uptake during renal scanning in unknown bone metastases

We report a patient with DTPA and DMSA uptake on unsuspected bone metastases. He had severe pain due to grade 3 hydronephrosis of his left kidney. When Tc-99m DTPA and DMSA renal scanning were performed for preoperative evaluation, abnormal radiopharmaceutical uptake on the iliac area was noted. Pancreatic adenocarcinoma metastases to bone were subsequently defined. This patient is a very demonstrative case in respect of having all DTPA, DMSA and HDP uptakes in bone metastases. The type of the tumor has to be added to the list of extrarenal uptake of DTPA and DMSA as a rare cause.