Incidental Detection of Mandibular Metastasis in Renal Cell Carcinoma on 99mTc-MIBI Scan.

MIBI scintigraphy is the most widely used modality to identify parathyroid adenomas preoperatively. However, MIBI is also known to accumulate in multiple benign and malignant lesions. In renal cell carcinoma, 30% of the patients present with distant metastasis, commonly lungs and bone; however, jaw bone metastases are extremely rare (<1% of oral malignancies). Here we present a rare case of MIBI-avid mandibular metastasis in bilateral renal cell carcinoma on 99mTc-MIBI scintigraphy. Thus, we emphasize on careful interpretation of 99mTc-MIBI scans, which in addition to parathyroid adenomas can incidentally detect concurrent malignant lesions.