Primary High-grade Urothelial Carcinoma of the Prostate With Negative 18F-PSMA PET/CT Imaging

This case report describes an 81-year-old man with primary high-grade urothelial carcinoma of the prostate, which presented with a negative 18 F-PSMA PET/CT. Contrast-enhanced prostate MRI initially suggested a malignant lesion; however, 18 F-PSMA PET/CT revealed no significant tracer uptake. Postoperative immunohistochemical analysis demonstrated positivity for urothelial markers GATA3 and CK7, while prostate-specific markers PSA and AR were negative, confirming the diagnosis of primary high-grade urothelial carcinoma of the prostate. This case indicates that a negative PSMA PET/CT scan may serve as an important diagnostic clue in distinguishing non-adenocarcinomatous prostate malignancies.