68 Ga-PSMA PET/CT After Open Transvesical Prostatectomy: The Diagnostic Challenge of Postoperative Urinary Reflux.
Farid Jafari Zarrin Ghabaei, Amin Saber Tanha, Mohammad Ahmadi et al.
✦ AI-curated · Sources linked
Case in brief
A 68-year-old man with prostate adenocarcinoma discovered incidentally after open transvesical prostatectomy presented with focal uptake in the left seminal vesicle on 68Ga-PSMA PET/CT. Delayed imaging showed decreasing activity correlating with urinary clearance, and multiparametric MRI revealed no tumor extension, leading to the conclusion that the uptake was due to urinary reflux.
What made this case unusual
The case highlights urinary reflux into the seminal vesicle as a potential false-positive finding in patients with previous outlet-reconstructive surgery, which can mimic tumor invasion.
Diagnostic / clinical pearl
Clinicians should consider urinary reflux as a possible explanation for focal uptake in the seminal vesicle on PET imaging in patients with a history of prostate surgery.
Why it matters
This case underscores the importance of multimodality imaging correlation to prevent misinterpretation of PET findings, which could lead to unnecessary interventions.