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Metastatic Merkel Cell Carcinoma Incidentally Detected on PSMA PET/CT in a Patient With Metastatic Prostate Cancer
William Y Raynor1, Manas Ranpariya2, Jeffrey S Kempf1
1Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
None:
Positron emission tomography (PET) radiotracers targeting prostate-specific membrane antigen (PSMA) are now widely used in the evaluation of prostate cancer. However, PSMA activity has also been described in several nonprostatic malignancies, where PSMA is primarily expressed in tumor neovasculature. Here, we describe to the best of our knowledge the first case of a PSMA-avid Merkel cell carcinoma (MCC) inguinal lymph node metastasis, detected incidentally in an 80-year-old man with advanced metastatic prostate adenocarcinoma. Clinical history and disease distribution prompted the need for a diagnostic biopsy, confirming PSMA-avid metastatic MCC. This case highlights the importance of recognizing nonprostatic causes of PSMA uptake, as synchronous malignancies can alter diagnostic interpretation and treatment planning.
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