Abstract
The sternum is known as a relatively common site for bone metastases by a variety of malignant neoplasms. The usual finding is increased radiotracer uptake on bone scintigraphy, and cold metastasis is distinctly unusual. In addition, total nonvisualization of the sternum presenting as bone metastasis is extremely rare. We describe two cases with similar findings (absent sternum showing no activity of the sternal segments on bone scintigraphy), which corresponded to metastatic involvement. These findings were shown to be the first manifestation of hepatocellular carcinoma in one patient and bone metastasis in another patient with ovarian cancer.
Similar content being viewed by others
References
Urovitz EP, Fornasier VL, Czitrom AA (1977) Sternal metastases and associated pathologic fractures. Thorax 32:444–448
Otsuka N, Fukunaga M, Morita K, Ono S, Nagai K (1990) Photon-deficient finding in sternum on bone scintigraphy in patients with malignant disease. Radiat Med 8:168–172
Oates E, Staudinger KM (1989) Spectrum of appearance of cold sternal metastases in adults. Clin Nucl Med 14:702–703
Carrió I, Estorch M (1986) Cold sternal image as a sign of metastatic involvement. Clin Nucl Med 11:417–419
Toussirot E, Gallinet E, Augé B, Voillat L, Wendling D (1998) Anterior chest wall malignancies. A review of ten cases. Rev Rhum Engl Ed 65:397–405
Sher-Ahmed A, Buscema J, Sardi A (2002) A case report of recurrent epithelial ovarian cancer metastatic to the sternum, diaphragm, costae, and bowel managed by aggressive secondary cytoreductive surgery without postoperative chemotherapy. Gynecol Oncol 86:91–94
Noguchi H, Mori A (1994) A case of ovarian cancer with metastasis to the sternum and costae. Gynecol Oncol 52:416–419
Chiu TJ, Chen YJ, Huang CH (2008) Massive anterior chest wall metastasis of ovarian cancer and prolonged survival after treatment: a case report. J Reprod Med 53:373–377
Pavlakis G, Mountzios G, Terpos E, Leivaditou A, Papadopoulos G, Papasavas P (2006) Recurrent ovarian cancer metastatic to the sternum, costae, and thoracic wall after prolonged treatment with platinum-based chemotherapy: a case report and review of the literature. Int J Gynecol Cancer 16(Suppl 1):299–303
Lim ST, Sohn MH, Kwak JY, Yim CY (2002) Bone imaging of sternal metastasis from hepatocellular carcinoma with disease progression. Clin Nucl Med 27:311–312
Horita K, Okazaki Y, Haragushi A, Natsuaki M, Itoh T (1996) A case of solitary sternal metastasis from unknown primary hepatocellular carcinoma. Nippon Kyobu Geka Gakkai Zasshi 44:959–964
Reed JD Jr, Fishman EK, Kuhlman JE, Hruban RH (1989) Case report 535: hepatoma metastatic to the sternum. Skeletal Radiol 18:161–163
Mandell GA, Heyman S (1983) Absent sternum on bone scan. Clin Nucl Med 8:327
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sohn, MH., Lim, S.T., Jeong, Y.J. et al. Absent Sternum as the First Manifestation of Bone Metastasis on Bone Scintigraphy. Nucl Med Mol Imaging 44, 90–93 (2010). https://doi.org/10.1007/s13139-009-0015-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13139-009-0015-2