EXTRASKELETAL LOCALIZATION OF MDP IN SOFT-TISSUE SECONDARY TO METHOTREXATE INFILTRATION

This case involves a 15-year-old boy with non-Hodgkin lymphoma who suf fered infiltration of a methotrexate infusion from a right forearm int ravenous catheter, resulting in soft tissue erythema and swelling of t he right upper extremity. On a bone scan performed 6 days later to eva luate the sudden onset of nontraumatlc thoracic spine pain, there was normal spine activity but markedly increased uptake of Tc-99m MDP in t he right upper extremity soft tissues secondary to myonecrosis and sof t tissue microcalcification. Soft tissue uptake of skeletal tracers du e to chemotherapy extravasation has not been previously reported.