99m Tc-PSMA Scintigraphy of Subcutaneous Angiolipoma

Area of Science:

• Nuclear Medicine
• Oncology
• Pathology

Background:

• Prostate-specific membrane antigen (PSMA) scintigraphy is crucial for staging prostate cancer.
• False-positive findings can complicate diagnostic accuracy.
• Angiolipomas are benign tumors rarely encountered in PSMA imaging.

Purpose of the Study:

• To report a unique case of angiolipoma mimicking malignancy on PSMA scintigraphy.
• To highlight the potential for false-positive PSMA uptake in benign lesions.
• To emphasize the importance of histopathological correlation.

Main Methods:

• A 69-year-old man with prostate adenocarcinoma underwent 99m Tc-PSMA scintigraphy for staging.
• SPECT/CT imaging was used for lesion localization.
• Surgical excision and histopathological examination confirmed the diagnosis.

Main Results:

• PSMA scintigraphy showed focal uptake in the posterior abdominal wall.
• SPECT/CT confirmed a subcutaneous soft tissue lesion.
• Histopathology revealed the lesion to be an angiolipoma.

Conclusions:

• This is the first reported case of PSMA scintigraphy detecting an angiolipoma as a false positive.
• Angiolipomas should be considered in the differential diagnosis of focal PSMA uptake.
• Careful correlation with imaging and histopathology is essential for accurate diagnosis.