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Hypercalcemia and Abnormal Bone Scan Patterns

Roy E. Smith, MD
Arch Intern Med. 1985;145(7):1335. doi:10.1001/archinte.1985.00360070217048.
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To the Editor.  —In the September 1983 Archives, Licata and colleagues1 described a patient with multiple myeloma and acute hypercalcemia who presented with symmetrical juxta-articular uptake of technetium Tc 99m polyphosphate on bone scan. Licata et al postulated that the bone scan findings might be an early sign of an underlying hematologic neoplasm. A similar presentation was described by Liu2 in a patient with hypercalcemia and bone marrow involvement with malignant melanoma. The exact cause of the symmetrical uptake in the bone scans in these studies was not determined but was felt to be related to increased blood circulation in areas of tumor infiltration.

Report of a Case.  —A 56-year-old woman was admitted to the hospital with a ten-day history of weakness, fatigue, and dyspnea. Several weeks prior to admission, she was noted to have an enlarged right inguinal lymph node.Laboratory investigation disclosed the following values:


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