Bone imaging of sternal metastasis from hepatocellular carcinoma with disease progression

Solitary sternal metastasis from hepatocellular carcinoma is very rare. The authors describe interesting changes in bone scintigraphic patterns of a solitary sternal metastasis from hepatocellular carcinoma during disease progression. Images of the initial lesion showed a cold area with a peripheral rim of increased activity. Two years later without treatment, the lesion changed spontaneously to complete nonvisualization of the sternal body with greatly increased uptake of the manubrium. Bone metastasis was confined to the sternum even in the presence of a 2-year disease progression. Plain radiographs showed progressive osteolytic destruction of the sternal body and manubrium with a growing mass.