Skeletal metastasis usually happens by seeding of tumor emboli through bloodstream and also via retrograde venous blood flow or direct extension . Bone remodeling due to osteolytic and osteoblastic reactions form the basis of indirect evidence of skeletal metastasis in solid tumors. Whereas, the superiority of the FDG PET/CT in detecting bone marrow metastasis comes from the fact that it visualizes the metabolic activity of disseminated tumor cells directly in the bone marrow unlike bone marrow scintigraphy or other radiological methods which provides indirect evidence of skeletal metastasis .