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Prostate cancer metastasis to the spermatic cord is exceedingly rare. A 64-year-old man with a history of robotic-assisted radical prostatectomy for high-risk prostate adenocarcinoma (pT3b, Gleason 3+5=9) originating from a PI-RADS 5 lesion in the left prostate hemisphere presented with biochemical recurrence (PSA: 3.77 ng/mL) 6 years postoperatively. Whole-body 68 Ga-PSMA PET/CT revealed a solitary, hypermetabolic nodular mass in the contralateral (right) spermatic cord (SUVmax: 23.0), without local or distant metastasis. Surgical excision confirmed metastatic prostatic adenocarcinoma. This case highlights the crucial role of 68 Ga-PSMA PET/CT in detecting atypical soft tissue oligometastases and underscores a potential contralateral dissemination mechanism via pelvic vascular collaterals.
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Durman et al. (2026) studied this question.
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