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Lincoln's sign: where should we expect on 99mTc-MDP bone scintigraphy?

Classical appearance of "Lincoln's sign" on 99mTc-MDP bone scintigraphy has been described in literature in case of monostotic Paget disease of mandible showing increased radiotracer uptake in the body of mandible. This pattern has also been described as "black beard" sign. The monostotic presentation of Paget disease is rare, and involving the mandible, however, is very unusual. We present a case of carcinoma of the tongue with contiguous spread to the mandible presented in the similar fashion as the earlier reported Lincoln's sign or black beard sign on 99mTc-MDP bone scintigraphy. This appearance was confirmed with SPECT/CT, and the lytic sclerotic lesion of the mandible was confirmed.