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Coexistent Superscan and Lincoln Sign on Bone Scintigraphy

Kulkarni, Mukta, DNB*; Soni, Atul, MCH; Shetkar, Shubhangi, DNB; Amer, Momin, MBBS; Mulavekar, Amruta, MBBS; Joshi, Prathamesh, DRM, DNB*

doi: 10.1097/RLU.0000000000001714
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A 70-year-old man underwent 99mTc–methylene diphosphonate scintigraphy for staging of adenocarcinoma prostate. Scintigraphy revealed diffuse increased tracer uptake in skeletal system along with faint renal visualization, a pattern compatible with metastatic superscan. The scintigraphy also revealed increased radiotracer uptake in the body of the mandible—Lincoln sign or black beard sign. Radiological imaging revealed sclerotic lesions throughout the skeleton including the mandible, confirming widespread skeletal metastases. Lincoln sign is previously described in monostotic Paget disease of the mandible and in contiguous spread of oral malignancy. We describe this pattern in distant metastatic involvement from carcinoma prostate with coexistent superscan pattern.

From the *Department of Nuclear Medicine, Tapadia Diagnostic Centre; †Soni Hospital; and ‡Department of Radiology, Tapadia Diagnostic Centre, Aurangabad, India.

Received for publication February 22, 2017; revision accepted April 7, 2017.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Prathamesh Joshi, DRM, DNB, Department of Nuclear Medicine, Tapadia Diagnostic Centre, Aurangabad 431001, India. E-mail:

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