Key result
68Ga-PSMA PET/CT shows nonspecific uptake in a synchronous paraganglioma masquerading as prostate cancer metastasis.
Why the study?
68Ga-PSMA PET/CT tracer avidity is known to occur in multiple nonprostatic benign and malignant lesions, raising uncertainty about its specificity for prostate cancer metastasis.
Case Report (n=1)
68Ga-PSMA PET/CT can show nonspecific uptake in nonprostatic lesions such as paraganglioma, mimicking metastasis.
Atypical solitary PSMA-avid lesions in prostate cancer may represent paraganglioma; extends non-prostatic uptake spectrum, hypothesis-generating for biopsy decisions.
We present a case of biopsy-proven prostatic adenocarcinoma with a tracer-avid left paravertebral location at D4 to D5 vertebrae, suggestive of metastasis. However, in view of uncommon location of single-site metastasis at paravertebral region with no tracer-avid regional lymphadenopathy, image-guided biopsy was done, which was suggestive of paraganglioma. Ga-PSMA is known to have variable tracer avidity in multiple nonprostatic benign as well as malignant lesions, and our case adds to the list of nonspecific uptake by this once considered "specific" to prostate PET radiotracer.
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Tyagi et al. (2019) conducted a case report in Prostatic adenocarcinoma (n=1). 68Ga-PSMA PET/CT was evaluated on Tracer avidity. 68Ga-PSMA PET/CT demonstrated nonspecific tracer uptake in a synchronous paraganglioma, masquerading as a metastasis in a patient with prostatic adenocarcinoma.
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