Demonstration of a congenital urine bladder diverticulum by 99mTc-MDP SPET/CT scan in a female with bone metastases.

Urine bladder diverticula are usually asymptomatic, therefore they are incidentally diagnosed during examinations for other purposes. A Chinese patient, with a history of pulmonary adenocarcinoma first underwent a technetium-99m methylene diphosphonate whole-body bone scan. In addition to multiple skeletal metastases, abnormal shape of the urine bladder was also noted, which overlapped the superior ramus of the right pubic bone. In order to: a) better delineate the shape and structure of the urine bladder; b) visualize the pubic bone and c) detect the exact location and structural changes of skeletal lesions in the lumbosacral region, single photon emission tomography/computerized tomography (SPET/CT) scan of this region was performed immediately, and demonstrated: a) a big urine bladder diverticulum in the right hemipelvis; b) structural changes of skeletal metastases while metastases in the pubic bone were ruled out. An overview of the etiology, histopathology, complications, management and imaging of urine bladder diverticulum is also presented. We consider our case the first to be diagnosed by SPET/CT and differentiated from metastases of the overlapping bone in a 69 years old female.