Widespread osseous metastasis of signet ring type bladder cancer detected by NaF18-PET/CT bone scan

Abstract

We present a case of a 70 year old black male with innumerable small osseous metastases which were not visible on FDG-PET/CT or CT and were only detected by NaF18-PET/CT bone scan. To our knowledge, this is the first case in the literature reporting the use of NaF18-PET/CT bone scan in the initial staging of signet ring cell bladder carcinoma. Metastatic bone disease was widely spread throughout the skeleton. Some bladder cancers are detected in late stages and have occult distant metastases. Signet ring type adenocarcinomas of the bladder are very rare and they have a very aggressive nature. Proper staging can save the patients from undue surgical procedures. NaF-PET/CT may be a necessary tool in the diagnostic staging of aggressive bladder cancers.