What question did this study set out to answer?

This case report aims to illustrate the diagnostic complexities when assessing periprostatic masses with elevated PSA levels.

May 9, 2026

Elevated PSA with low 68 Ga-PSMA and 18 F-FDG uptake in a periprostatic perineurioma

Key Points

This case report aims to illustrate the diagnostic complexities when assessing periprostatic masses with elevated PSA levels.
A 68-year-old male presented with dysuria and elevated PSA levels.
Contrast-enhanced CT and PET/MRI with both 68 Ga-PSMA and 18 F-FDG were performed to evaluate the mass.
Histopathological analysis confirmed the diagnosis following imaging studies.
The maximum standardized uptake value was 2.4 for both tracers, indicating low uptake.
Histopathology confirmed periprostatic perineurioma with benign characteristics and a Ki67 index of 1%.
Multimodal imaging effectively helped characterize the tumor, differentiating it from malignancies.

Abstract

A 68-year-old male patient presented with a 4-month history of dysuria and an elevated prostate-specific antigen (PSA) level of 21.4 ng/mL. Contrast-enhanced CT revealed a purely extraprostatic 5-cm anterior periprostatic mass. 18 F-fluorodeoxyglucose ( 18 F-FDG) and 68 Ga-prostate-specific membrane antigen ( 68 Ga-PSMA) positron emission tomography/magnetic resonance imaging (PET/MRI) revealed low dual-tracer uptake (maximum standardized uptake value SUV max = 2.4 for both tracers) with benign features, including neural tumor-specific T2 septations, preserved apparent diffusion coefficient (ADC), and type 2 plateau enhancement. Histopathological analysis confirmed the diagnosis of periprostatic perineurioma (epithelial membrane antigen EMA+/CD34+/S100-, Ki67 index 1%). This case highlights the value of multimodal PET/MRI for accurate characterization of pelvic tumors, particularly in distinguishing rare benign entities from malignancy.

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Cite This Study

Lu et al. (Wed,) studied this question.

synapsesocial.com/papers/69fecfcdb9154b0b82876bec https://doi.org/https://doi.org/10.65457/jnmmi-2026-0026

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