Unusual Site of Solitary PSMA-Positive Recurrence of Prostate Cancer in an Undescended Testis

Prostate cancer is the most frequently diagnosed malignancy among men. Biochemical recurrence occurs in ∼20%-40% of patients and poses a significant clinical challenge. PSMA-PET/CT has emerged as a highly sensitive and specific imaging modality for detecting recurrent and metastatic prostate cancer, outperforming conventional imaging, especially at low PSA levels. We report an unusual site of metastatic recurrence detected on [¹⁸F]-Piflufolastat PSMA PET/CT in a patient with rising PSA. This case highlights the crucial role of advanced molecular imaging in accurately identifying atypical metastatic spread, which may have a direct impact on clinical decision-making.