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Reversible Tc‐99m Diphosphonate Uptake in Gastric Tissue Associated With Malignancy Related Hypercalcemia A Comparative Study Using PET FDG Whole Body Imaging

A 52-year-old man with metastatic poorly differentiated bronchogenic carcinoma and serum calcium levels as high as 14.6 had intense Tc-99m MDP uptake found throughout the stomach wall on SPECT imaging. FDG uptake assessed by PET imaging was not elevated in the stomach, whereas multiple hyper-metabolic tumor foci could be found throughout the body. Three months later, when calcium levels normalized, no Tc-99m MDP uptake was found in the stomach despite persistence of neoplastic lesions elsewhere. This case study indicates that gastric MDP uptake in patients with malignancy related hypercalcemia can be reversible and not necessarily indicative of neoplastic infiltration.