99m Tc-PSMA Uptake in Neurofibroma.

Area of Science:

• Oncology
• Nuclear Medicine
• Pathology

Background:

• Prostate cancer staging relies on accurate imaging to detect metastasis.
• Prostate-specific membrane antigen (PSMA) PET imaging is increasingly used for prostate cancer staging.
• Incidental findings during PSMA PET scans can reveal unexpected pathologies.

Purpose of the Study:

• To report an incidental finding of a neurofibroma during PSMA PET/CT staging of prostate cancer.
• To discuss the potential for PSMA avidity in neurological lesions.
• To review literature on PSMA expression in non-prostate cancer tissues.

Main Methods:

• A 74-year-old male with high-risk prostate cancer underwent staging with 99mTc-HYNIC-PSMA PET/CT.
• Incidental increased uptake was noted in the left skull region.
• SPECT/CT confirmed uptake in a subcutaneous scalp nodule, which was pathologically analyzed.

Main Results:

• The PSMA PET/CT scan showed metastatic prostate cancer (miT2m N2 M1b M1c).
• Incidental uptake in the scalp was localized to a subcutaneous nodule.
• Pathological analysis confirmed the scalp nodule to be a neurofibroma.

Conclusions:

• Neurofibromas can exhibit significant PSMA avidity.
• Incidental findings on PSMA PET/CT require careful evaluation and pathological correlation.
• Understanding PSMA expression in various tissues is crucial for accurate interpretation of staging scans.