An interesting bone scan in multiple myeloma—? myeloma superscan

Abstract

In bone imaging the term “superscan” has been used to describe the appearance of high skeletal uptake of radionuclide combined with low background activity (Osmond etal, 1975). It is usually accompanied by absent or faint renal activity (Sy et al, 1975). This appearance has been associated with two main pathological groups. It may occur in widespread metastatic bone disease (Thrupkaew et al, 1974; Constable & Cranage, 1981), and it is also recognised in certain metabolic bone disorders (Sy & Mittal, 1975). The use of bone imaging as part of the staging of multiple myeloma has not proved as sensitive as with other bone-seeking tumours because the myeloma deposits may be normal on the scan. The deposits may also appear as areas of low uptake, which are not always as readily appreciated as areas of high uptake. (Woolfenden et al, 1980; Leonard et al, 1981). We present a case of multiple myeloma which we believe showed a superscan appearance on bone imaging with 99Tcm methylene disphosphonate. As far as we can ascertain this has not been previously reported.