“Superscan” Scintigraphic Version for Prostate Cancer

Abstract

A rare scintigraphic phenomenon of “superscan” is considered – an abnormally high diffuse accumulation of osteotropic radiopharmaceutical by all skeletal parts in combination with the absence of kidney and tissue background imaging. This feature reflects a generalized bone system lesion of metastatic, metabolic or hematological nature. We present a clinical observation and retrospective assessment of scintigraphic data obtained during controlling androgen deprivation therapy in a patient with prostate cancer. Based on the analysis of “superscan” signs, including 99mТс-pyrophosphate hyperfixation by skull bones, as well as concomitant levels of prostatic specific antigen and parathyroid hormone (PTH), it was suggested that the identified scintigraphic phenomenon had metabolic nature, and its occurrence was possibly due to ectopic production of both PTH and parathyroid hormone-related protein, playing a well-known role in prostate cancer genesis.