An 82-year-old man on active surveillance for low-risk prostate cancer underwent 18 F-DCFPyL PET/CT PET/CT for rising PSA. Imaging revealed interval progression of known intraprostatic malignancy. Interestingly, intracranial uptake was seen along the right frontoparietal convexity, corresponding to a known chronic subdural hematoma (cSDH) in this patient who had previously undergone middle meningeal artery embolization. This case highlights prostate-specific membrane antigen (PSMA) expression associated with cSDH, likely reflecting inflammation-driven neoangiogenesis. Recognition of such uptake is essential to avoid misinterpretation as metastatic disease and may provide novel insights into cSDH pathophysiology and potential therapeutic targets.
Mumtaz et al. (Tue,) studied this question.