Mixed form lymphatic malformation of the foot simulating acute soft-tissue lesion on 3-phase bone scintigraphy

A 15-year-old girl who presented with a congenital masslike soft-tissue lesion involving the second and third toes of the left foot was evaluated with various imaging modalities. Tc-99m methylene diphosphonate (MDP) 3-phase bone imaging was performed for further assessment of the lesion and to evaluate the underlying osseous structures, which showed increased tracer uptake on the first 2 phases. A mixed-form lymphatic malformation (LM) was diagnosed based on the typical clinical history, physical examination, and imaging findings. Despite the rarity of this condition, this report concludes that soft-tissue LM should be considered in the differential diagnosis when increased focal blood flow and soft-tissue uptake are seen on 3-phase bone scintigraphy.