Giant abdominal aortic aneurysm in bone scan

Abstract

Abdominal aortic aneurysm (AAA) may be incidentally detected in three-phased bone scintigraphy. AAA should be diagnosed prior to the development of symptoms to perform elective repair surgery. We present a rare case who presented with back pain and underwent a 3-phase bone scan with Tc-99m methylene diphosphonate, which revealed a giant AAA on blood-flow and blood-pool phases in addition to bone metastases. F-18-fluorodeoxyglucose positron emission tomography/computed tomography (CT) identified hypermetabolic liver, lung, and bone lesions, and CT component of the study confirmed the diagnosis of AAA with a maximum diameter of 92 mm. The initial two phases of a 3-phase bone scintigraphy are decisive to identify vascular pathologies that may be life-threatening, if left untreated.