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SPECT/CT imaging of a retroperitoneal nodule in a patient with history of infiltrating renal urothelial carcinoma.

A 62 year old woman status post radical nephroureterectomy for high grade urothelial carcinoma was found on CT to have a 1 cm retroperitoneal nodule in the nephrectomy bed. The nodule's differential diagnosis included recurrent urothelial carcinoma versus relocation of the patient's splenule seen on earlier CT imaging. We report using SPECT/CT with Tc-99m labeled denatured red blood cells to definitively diagnose the nodule as a relocated splenule.