Clinical Presentation
A 3-year-old boy with treated neuroblastoma presents for restaging. What is the etiology of the appearance of the spine?
Anterior and posterior whole-body bone scan demonstrates abrupt decrease in radiotracer accumulation in the mid and lower thoracic spine (circle).
Differential Diagnosis
• Normal prior external beam radiation effect: The sharply marginated, diffusely decreased activity at multiple adjacent vertebral levels makes this the most likely etiology.
• Lytic osseous metastases:
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