Asymptomatic Prostate Cancer Brain Metastases on 68Ga-PSMA PET/CT

Brain metastases from prostate cancer are rare and occur at a late stage in the natural history of the disease. Men usually present with neurological manifestations. We present a 66-year-old asymptomatic man who had incidental brain metastases detected on Ga-PSMA PET/CT, which was later confirmed on biopsy to be prostate adenocarcinoma. With newer androgen deprivation agents and improved imaging capabilities increasing the mean survival and thus the incidence of brain metastases from prostate cancer, it is important to consider this important differential not only in men who display neurological symptoms but also in men who are asymptomatic.