Pneumothorax as an incidental finding on a bone scan – importace of a hybrid imaging

Overview

In the present case report, we describe a case of an incidental finding of left-sided pneumothorax on bone scintigraphy in an 81-year-old man referred to our department for staging of prostate cancer. The patient had undergone pacemaker insertion 6 days prior to the bone scintigraphy examination at another health care facility, where even a follow-up chest radiograph did not demonstrate a pneumothorax. On examination, he underwent a wholebody scan in anterior and posterior projections, supplemented by hybrid SPECT/low dose CT scan of the head and trunk, where we found a left-sided pneumothorax in addition to the suspected bone metastases in the skull. The patient was ad hoc referred to the Cardiac Surgery Unit for thoracic drainage, which was successful and the patient was discharged to home care after a short hospitalization. The case report highlights the benefit of comprehensive evaluation of hybrid imaging techniques in nuclear medicine, which ensure that incidental, but often very serious, findings do not escape attention.

Keywords:

bone scan – pneumothorax – SPECT/low dose CT