Case highlights incidental detection of intrahepatic cholangiocarcinoma using PSMA PET in metastatic prostate cancer, suggesting the need for multidisciplinary care.
Intrahepatic cholangiocarcinoma (ICC) is a rare hepatobiliary malignancy often diagnosed at advanced stages due to its silent progression. Prostate-specific membrane antigen (PSMA) PET/CT, primarily used in prostate cancer, can incidentally detect unrelated malignancies. In a patient with metastatic castration-resistant prostate cancer (mCRPC), PSMA PET/CT revealed a liver lesion initially presumed metastatic. However, lack of uptake on post-therapy single-photon emission computed tomography/CT (SPECT/CT) prompted further evaluation, and MRI with biopsy confirmed ICC. The patient received intensity-modulated radiation therapy (IMRT) for ICC, stereotactic body radiation therapy (SBRT) for prostate metastases, and continued Lu-177 PSMA-617 therapy. This case highlights the incidental diagnostic value of PSMA PET and the importance of post-therapy imaging and multidisciplinary care in managing complex cancer presentations.
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Kulkarni et al. (2025) studied this question.
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