Avid (67)Ga uptake in multiple myeloma relapsing after bone marrow transplant

Technetium-99m-sestaMIBI is a reliable positive tracer of skeletal lesions in multiple myeloma (MM), while bone scintigraphy by 99mTc-MDP and 67Ga scanning are considered of negligible value. We report the case of a young patient with a 5-year history of light chain MM, which was not eradicated by chemotherapy, radiotherapy, allogeneic bone marrow transplantation, α-interferon and donor lymphocyte infusion. In the final phase of the disease a CT scan showed a 14 cm mediastinal mass (Figure 1A). The neoplastic tissue took up 67Ga more avidly than 99mTc-sesta MIBI (Figures 1B-C), and focal bone lesions showed 67Ga uptake even in areas negative by MIBI scan. The patient died of disease progression in a few months. It seems that a 67Ga scan can identify patients with very aggressive MM.