A 45-year-old man returned to the hospital with hemoptysis two months after left lower extremity amputation for recurrent giant-cell tumor of the left tibia. Chest radiographs revealed multiple metastatic pulmonary nodules, and chest CT scan identified calcium in some of the nodules. Because of recurrent hemoptysis, the patient returned to the hospital two months later and underwent a chest radiograph that revealed progression of the metastases. A Bone scan revealed striking pulmonary uptake of Tc-99m HDP in the metastatic lesions. No secondary reasons for the pulmonary uptake of Tc-99m HDP, such as hypercalcemia or uremia, were present.
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