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Symmetrical Bone Scan in Acute Hypercalcemia

Tom T. Liu, MD
Arch Intern Med. 1984;144(9):1897. doi:10.1001/archinte.1984.00350210227054.
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To the Editor.  —In the September Archives Licata and colleagues1 described a patient with multiple myeloma with acute hypercalcemia in whom a symmetrical juxta-articular uptake of technetium Tc 99m polyphosphate was seen on a bone scan. They believed this association of symmetrical lesions on a bone scan in a patient with asymptomatic joints and acute hypercalcemia might be an early sign of an underlying hematologic malignant neoplasm.

Report of a Case.  —A 42-year-old woman was admitted to the hospital complaining of a four-week history of anorexia, stiffness, weakness of her shoulder muscles, and some difficulty in walking due to muscular weakness. Five years prior to admission, she had had a malignant melanoma removed from her left thigh. Physical examination disclosed mild proximal muscle weakness, but no joint abnormalities were noted.Laboratory investigations disclosed the following values: hemoglobin, 11.9 g/dL; ESR, 104 mm/hr; calcium, 16.9 mg/dL; phosphorus, 5.6 mg/dL; creatinine,


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