All that glitters is not prostate cancer: incidental finding of PSMA-avid meningioma

We present a case of a 79 year old patient with a medical history of unilateral nerve-sparing radical prostatectomy due to a pT3aN0 (Gleason score 7) prostate carcinoma. Because of slightly elevated prostate specific antigen (PSA) level (0.35ng/dL), a fluorine-18-prostate specific membrane antigen (¹⁸F-PSMA)-1007 positron emission tomography/computed tomography (PET/CT) scan was performed, showing no signs of malignant recurrence. However, a moderately PSMA-avid nodular lesion was observed in the left occipital region with homogeneous contrast enhancement, suggestive for a meningioma, which was confirmed on magnetic resonance imaging (MRI). One year later, the lesion was resected due to a small but significant growth. Histology confirmed the diagnosis of a transitional type meningioma (WHO grade 1).