Testicular Metastasis From Prostate Cancer Demonstrated on PSMA PET/CT

Testicular metastasis from prostate cancer is rarely reported in radiology literature. We present the case of an 84-year old man with history of prostate cancer, who obtained an 18 F-Pylarify PET/CT for biochemical recurrence, with an incidentally detected prostate-specific membrane antigen-avid large right testicular mass. The 18 F-Pylarify PET/CT showed no evidence of local prostate tumor recurrence in the prostate bed, but demonstrated small right common and external lymph node metastases in addition to the incidentally noted large right testicular mass. The patient underwent orchiectomy with subsequent histopathologic examination confirming metastasis from prostate cancer.