Cutaneous and Subcutaneous Prostate-Specific Membrane Antigen-Avid Lesions.

Area of Science:

• Oncology
• Nuclear Medicine
• Dermatology

Background:

• Metastatic castration-resistant prostate cancer (mCRPC) can present with rare cutaneous involvement.
• Diagnosis of subcutaneous prostate cancer metastases can be challenging, particularly with atypical presentations.
• Prostate-specific membrane antigen (PSMA) avidity in skin lesions indicates metastatic disease.

Purpose of the Study:

• To report a case of mCRPC with PSMA-avid subcutaneous metastases treated with 177 Lu-PSMA therapy.
• To emphasize the diagnostic challenges of cutaneous prostate cancer metastases.
• To review causes of PSMA-avid cutaneous and subcutaneous lesions.

Main Methods:

• Case report of a 62-year-old man with mCRPC and subcutaneous nodules.
• Diagnostic confirmation via biopsy and immunohistochemistry.
• Treatment with three cycles of 177 Lu-PSMA therapy.
• Review of literature on PSMA-avid skin lesions.

Main Results:

• The patient presented with PSMA-avid subcutaneous nodules and edema.
• Biopsy confirmed cutaneous metastases from prostate cancer.
• 177 Lu-PSMA therapy led to decreased PSA levels and symptom resolution.
• The review identified various causes of PSMA-avid skin lesions.

Conclusions:

• 177 Lu-PSMA therapy can be effective for mCRPC with subcutaneous involvement.
• Early diagnosis of cutaneous prostate cancer metastases is crucial.
• Understanding PSMA avidity in skin lesions aids in diagnosis and management.