Imaging with Tc-99m labeled red blood cells (RBC) is increasingly being used in the detection of acute gastrointestinal bleeding, especially in patients with intermittent bleeding. A patient is presented in whom the labeled RBC scan was helpful in the incidental discovery of a previously unsuspected probable angiosarcoma of the right femur and adjacent soft tissues of the right hip due to the ldquo;blood poolrdquo; or ldquo;blush effectrdquo; of the labeled cells. The labeled RBC scan also identified extravasation due to active gastrointestinal bleeding from a previously unknown angiosarcoma of the ascending colon. Thus, the Tc-99m labeled RBC scan was useful in simultaneously detecting extravasation and blood pool effect at two remote tumor sites in the same patient.
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