PET/CT Identifies Pubic Melorheostosis with High ⁶⁸Ga-PSMA Uptake in a Patient with Prostate Cancer

Melorheostosis, a rare benign bone disorder marked by cortical thickening and irregular hyperostosis, typically affects peripheral bones but can also involve the axial skeleton. Though various molecular imaging radiotracers have been used to evaluate this condition, there are no previous reports of positive ⁶⁸Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (⁶⁸Ga-PSMA PET/CT) findings in melorheostosis. This case presents a 70-year-old man with metastatic prostate cancer whose ⁶⁸Ga-PSMA PET/CT scan revealed intense ⁶⁸Ga-PSMA uptake in pubic melorheostosis seen on magnetic resonance imaging. The case highlights the possibility of ⁶⁸Ga-PSMA-avid melorheostosis and suggests ⁶⁸Ga-PSMA PET/CT may have a role in the evaluation of melorheostosis.