Breast ^99mTc-MDP uptake in a man mimicking metastatic lesion of the ribs

A 65 year-old overweight man with a history of prostate cancer was referred to our nuclear medicine department for bone scanning. Anterior projection images showed two small foci of increased radiotracer uptake corresponding to the anterior arcs of the right and left sixth ribs, which were interpreted as suspicious for metastatic involvement. Eight months later the patient was referred for follow-up bone scan. In the follow-up scan, those two foci of abnormal radiotracer activity were outside the limits of the bony structures of the chest. In fact, those foci changed their position and were due to radiotracer uptake by the enlarged breasts of this gentelman (Gynecomastia). Previously, it has been just one report concerning radiotracer uptake in the breasts of a man. Based on our case report, this abnormal finding is not exclusively observed in women and it can be also seen in men who suffer from gynecomastia. Physical examination in these settings can be extremely helpful. Oblique, lateral and SPECT (Single Photon Emission Tomography) views can also confirm the extraskeletal origin of radiotracer uptake.