Diffuse Hepatic Uptake of Tc-99m MDP in Acute Hepatic Failure Caused by Excessive Use of Analgesic Drugs

Hepatic uptake of technetium-99m methylene diphosphonate (Tc-99m MDP) is an unexpected and rare finding on bone scintigraphy. Focal hepatic uptake was reported in metastatic breast and colon cancers; however, diffuse and intense uptake is extremely rare. In this case, we report the case of a 74-year-old female admitted to the hospital with acute hepatic failure and acute kidney injury diagnoses, who has a history of breast cancer. Due to intense low back pain, a bone scan was performed for the evaluation of metastatic disease. Bone scan revealed diffuse intense Tc-99m MDP uptake in the liver, secondary to acute hepatic failure.