Intramedullary Spinal Cord Metastasis (SCM) From Prostate Carcinoma Detected on [68Ga] Ga-PSMA-11 PET/CT

Prostate carcinoma metastasizing to the spinal cord is an extremely rare entity. We present a 70-year-old man with prostate carcinoma with a Gleason's score of 10 and an elevated serum prostate-specific antigen (PSA) of 25.99 ng/mL. He underwent [68Ga] Ga-prostate-specific membrane antigen (PSMA)-11 positron emission tomography (PET)/computed tomography (CT) imaging for initial staging. The PET/CT revealed a high-grade [68Ga] Ga-PSMA-11 expressing primary prostatic lesion and metastatic abdomino-pelvic lymph nodes and skeletal lesions. Focal moderate grade [68Ga] Ga-PSMA-11 uptake was noted in the spinal cord at the cervical region, suggestive of spinal cord metastasis (SCM). Thus, in the present case, the rare occurrence of SCM in prostate carcinoma in a recently detected, untreated patient is underscored, indicating the high diagnostic performance of [68Ga] Ga-PSMA-11 PET/CT for accurate disease staging.