Symmetrical Bone Scan in Acute Hypercalcemia

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,