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Evolution of hyperostosis frontalis interna butterfly sign demonstrated by bone scan.

Hyperostosis frontalis interna is a term used to describe the thickening of the internal table of the frontal bones. The exact cause is unknown, but reports in the literature suggest that hyperostosis is a mark of disordered bone metabolism, with increased androgen and prolactin levels suggesting an association in elderly women. A 48-year-old woman with lobular carcinoma of the breast had a bone scan for possible bone metastases. A scintigraphic follow-up examination revealed a butterfly appearance that was not present on previous scans of the frontal bone.