Abstract
A 65-year-old man presented with pulmonary nodules and a right humeral fracture. The 99mTc-hydroxy-methylene-diphosphonate (HMDP) bone scintigraphy showed high-intensity radioisotope (RI) uptake by a tumor of the right arm. Adenocarcinoma of the lung with an epidermal growth factor receptor (EGFR) mutation was diagnosed on pathological examination of the computed tomography (CT)-guided needle biopsy of the right humerus. Although, gefitinib therapy was initiated, the tumor progressed. The patient was then treated with second-line chemotherapy including bevacizumab. The CT scan showed a new bone metastasis in the ilium and right sacroiliac articulation. However, this new bone metastasis was not detected by HMDP-bone scintigraphy. Physicians should be wary of the interpretations of the findings of the 99mTc HMDP bone scintigraphy after the bevacizumab treatment.
MeSH terms
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Adenocarcinoma / diagnostic imaging
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Adenocarcinoma / drug therapy*
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Adenocarcinoma / genetics
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Adenocarcinoma / pathology
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Adenocarcinoma of Lung
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Aged
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Bevacizumab / administration & dosage*
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Bone Neoplasms / diagnostic imaging
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Bone Neoplasms / drug therapy*
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Bone Neoplasms / pathology
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Bone Neoplasms / secondary
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ErbB Receptors / genetics
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Gefitinib
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Humans
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Humerus / diagnostic imaging
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Lung Neoplasms / diagnostic imaging
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Lung Neoplasms / drug therapy*
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Lung Neoplasms / genetics
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Lung Neoplasms / pathology
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Male
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Mutation
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Quinazolines / administration & dosage
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Radiography
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Radionuclide Imaging*
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Technetium Tc 99m Medronate / administration & dosage
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Technetium Tc 99m Medronate / analogs & derivatives
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Tomography, Emission-Computed
Substances
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Quinazolines
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Bevacizumab
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technetium Tc 99m hydroxymethylene diphosphonate
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EGFR protein, human
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ErbB Receptors
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Gefitinib
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Technetium Tc 99m Medronate