Bone SPECT/CT imaging of a liposclerosing myxofibroid tumor in an unexpected localization

Background The combination of both functional and morphological information using three-phase bone scintigraphy and tomographic imaging with single photon emission tomography/computed tomography (SPECT/CT) allows precise characterization of most bone lesions. The hybrid imaging is most useful when conventional imaging is equivocal or contraindicated (e.g magnetic resonance imaging (MRI). Case presentation A 69-year old, male patient with moderate pain in his posterior pelvic region was diagnosed with an unclear tumor of the iliac bone. Conventional radiographs, computed tomography (CT), and MRI imaging were inconclusive to confirm or refute a malignant process. There was no abnormal hyperperfusion on the early images. On the delayed images, moderately increased osteoblastic activity was noted, and the provisional diagnosis was in favor of a benign process. Histopathology confirmed a benign liposclerosing myxofibrous tumor located in the left iliac bone. Conclusion Bone scan SPECT/CT might (a) help in classifying bone lesions by combining their metabolic and morphological (e.g CT) characteristics and (b), might help in discriminating benign and malignant tumors.