Hyperostosis frontalis interna by bone scintigraphy

A 70-years-old female with a past history of breast cancer underwent a [99mTc] Hydroxy-Diphosphonate (HDP)-bone-scintigraphy for staging. The examination revealed a symmetrically intense and diffuse radiotracer uptake in the skeleton with absent or diminished visualization of the genitourinary system (superscan pattern) (Fig. 1A), and a high and linear tracer uptake at the skull (Fig. 1A, arrow). Single-photon emission computed tomography/computed tomography (SPECT/CT) images showed the localized uptake only on the inner lamina of the frontal bones (Fig. 1B –D). No further examination was performed, so the malignancy could not completely be ruled out. However, this exclusive involvement of the inner lamina would be a rare presentation of malignancy. The diagnosis of hyperostosis frontalis interna (HFI) was made based on clinical and radiological findings, due to the diffuse uptake on the thicked inner lamina of the frontal bones, while the rest of the frontal and cranial bone structures were preserved. Furthermore, the patient presented with several factors, such as psychiatric disorders, neurological medication and menopause, which are also frequently associated with HFI. After 15 months of follow-up, the patient continues medical treatment without showing radiological changes on the frontal lesion.
Source: Japanese Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research