Extraosseous metastases of hepatocellular carcinoma detection and therapeutic assessment with Tc-99m PMT SPECT

Owing to recent advances in imaging technology and radiologic intervention, survival rates in patients with hepatocellular carcinoma have improved mar kedly. However, such prolonged survival has resulted in an increase in extr ahepatic metastases. Tc-99m (Sn)-N-pyridoxyl-5-methyltryptophan (Tc-99m PMT ), developed for hepatobiliary scintigraphy, has been used to visualize ext rahepatic metastases, with most related reports limited to osseous metastas es. The authors report two cases of hepatocellular cancer presenting as a h ypopharyngeal metastasis and intraperitoneal dissemination along the tract of a fine-needle biopsy. Lesions undetectable on planar Imaging could be vi sualized by Tc-99m PMT SPECT.