Incidental Detection of Glioblastoma Multiforme With PSMA Uptake on Initial Prostate Cancer Staging.
Mohammad Ahmadi, Amin Saber Tanha, Haniye Elahifard et al.
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Case in brief
A 75-year-old man with prostate adenocarcinoma underwent 99mTc-PSMA imaging for initial staging. The scan showed increased uptake in the skull; SPECT/CT localized a hypodense lesion to the brain parenchyma. He had recently developed left-sided hemiparesis. MRI and surgical pathology established glioblastoma multiforme in the PSMA-avid lesion, rather than a prostate cancer metastasis.
What made this case unusual
The intracranial glioblastoma showed PSMA uptake on prostate cancer staging imaging, creating a potential pitfall in interpreting an atypical avid lesion as metastatic disease.
Diagnostic / clinical pearl
PSMA-avid lesions outside the expected pattern of prostate cancer spread warrant anatomical correlation and evaluation; in this case, SPECT/CT, MRI, and pathology identified a primary brain tumour.
Why it matters
The authors note that PSMA uptake in glioblastoma may offer a potential target for theranostic approaches.