Discovery of a renal medullary carcinoma in an adolescent male with sickle cell trait by Tc-99m methylene disphosponate bone scintigraphy.

The renal excretion of Tc-99m bone imaging agents often permits the identification of urinary tract abnormalities on bone scans. In this case report, identification of focal intrarenal stasis of the excreted bone imaging agent led to additional anatomic imaging and the identification of a renal medullary carcinoma (RMC) in an adolescent black male undergoing evaluation for back pain. RMC is a rare, highly aggressive renal neoplasm found almost exclusively in young individuals with sickle cell trait (SCT) or hemoglobin SC disease. The prognosis of RMC is poor because the malignancy is usually refractory to chemotherapy and radiotherapy, with metastatic disease commonly present at the time of diagnosis.