León CR, Sánchez LM, Durán TG, Gómez VN, Menéndez PR, Martín EJM, Rodríguez PL, Real CRM

Language: Spanish
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ABSTRACT

Objective: To demonstrate the value of single photon emission tomography with 99m technetium-methoxy-isobutyl-isonitrile for brain metastasis diagnosis and the differentiation from an infectious lesion.
Clinical case: A 65-year-old male patient started with myoclonic focal seizures of the right upper limb. Left progressive external ophthalmoparesis was associated. A simple cranial magnetic resonance with gadolinium was performed. The characteristics of the left parietal lesions and the mesencephalon level were not conclusive to establish an etiological diagnosis. A single-photon emission tomography with 99m technetiummethoxy- isobutyl-isonitrile was indicated to clarify the nature of this lesion, which was performed at Hermanos Ameijeiras Hospital. This study showed uptake of the radiopharmaceutical in both lesions. A left temporal uptake was also found in an area that is not observed lesion in the simple or contrasted magnetic resonance study. Considering that all the lesions captured the radiopharmaceutical, and that the uptake of this radiopharmaceutical in the brain only occurs in tumor lesions, the etiology of the lesions was diagnosed as metastatic.
Conclusions: The procedure was a useful diagnostic tool to non-invasively identify the metastatic brain lesions and exclude infectious lesions in the patient.