Cancer de la prostate et masses abdominopelviennes fixant le 99mTc-HDP. Apport de la tomographie d'émission monophotonique couplée à la tomodensitométrie (TEMP-TDM)

We report the case of a 63-year-old man, investigated for staging of a prostatic cancer, diagnosed by biopsy, following a rise in the prostatic specific antigen (PSA) on a systematic assessment. The interrogation before examination revealed signs of beginning right crural neuropathy. The hydroxymethylene diphosphonate technetium 99m-labeled (99mTc-HDP) whole-body bone scintigraphy highlighted two extraosseous uptake images, the first of moderated intensity in the right iliac area, the second milder, in the abdominal median area. Osseous metastases were not visualized. The single photon emission computerized tomography guided by computerized tomography (SPECT/CT) identified the median abdominal mass which corresponded to a bulky aneurysm of the under renal abdominal aorta. The right iliac mass could be accurately analyzed and differentiated from the various organs of the abdominopelvic cavity. Its lymphatic origin was hypothetised, but the diagnosis of lymphatic metastasis of the prostatic cancer was obtained by the pathologic examination of CT scan-guided biopsy.