Differential 18F-FDG and 18F-Fluciclovine Uptake Pattern in a Patient With Poorly Differentiated Adenocarcinoma of the Lung and Prostate Cancer Biochemical Recurrence
A 72-year-old man with a history of T1cN0M0 prostate adenocarcinoma and rising prostate-specific antigen underwent a fluciclovine PET/CT scan that showed high uptake in several para-aortic nodes, suspicious for prostate cancer. A right upper lobe single pulmonary nodule (SPN), demonstrated only mild uptake, which raised the suspicion for a lung primary. Subsequent FDG PET/CT showed high uptake in the SPN, revealing poorly differentiated adenocarcinoma at biopsy, but with no abnormal uptake in the para-aortic nodes. This case highlights the complementary potential of fluciclovine and FDG PET in patients with a history of prostate cancer biochemical recurrence and SPN.
A 50-year-old man with recently diagnosed prostate adenocarcinoma was referred for whole-body 68Ga–prostate-specific membrane antigen (PSMA) PET/CT scan for staging. Apart from some nonspecific findings, 68Ga-PSMA PET/CT revealed large soft tissue mass in the left upper abdomen showing heterogeneous tracer uptake. Histological examination of the mass was interpreted as gastrointestinal/extragastrointestinal stromal tumor by pathologists. Prostate-specific membrane antigen is considered specific for prostate cancer cells, although PSMA activity has been described in many other benign or malign conditions. That is why ...
is a major health problem. In the UK, it is the most common male cancer and the second most common cause of male cancer death. Its strongest predeterminant is increasing age. Virtually all cancers are adenocarcinomas, the grade being indicated by the Gleason score. There are often no presenting symptoms. Investigations such as serum prostate specific antigen, digital rectal examination, biopsy and, increasingly, magnetic resonance imaging (MRI) are required for diagnosis. Local staging consists of MRI, with computed tomography (CT), bone scanning and, increasingly, positron emission tomography-CT for detecting metastases.
CONCLUSIONS: The single-port approach has advantages as easier surgical planning and transition for combined and multi-quadrants surgeries: faster recovery, minimal postoperative pain and need for opioids, and excellent cosmetic outcome. We suggest that combined procedures should be performed only in high volume institutions by surgeons with vast experience in robotic surgery in selected patients. PMID: 31864774 [PubMed - as supplied by publisher]
A 63-year-old man, recently diagnosed with carcinoma of the prostate (Gleason’s score 4+4), with serum prostate-specific antigen 189.2 ng/mL, underwent 68Ga PSMA PET/CT scan for pretreatment staging. The study revealed abnormal tracer uptake in the prostatic bed region, the pelvic, abdominal, and mediastinal lymph nodes and diffuse metastases to the bilateral lungs. The lung metastasis was proved to be metastatic adenocarcinoma from analysis of bronchoalveolar lavage.
Tansel Cakir, Selcuk Guven, Bahar Muezzinoglu, Cengiz Erol, Mustafa Yucel Boz, Tamer AtaseverUrology Annals 2019 11(4):439-442 While 68Gallium prostate-specific membrane antigen positron emission tomography/computed tomography (68Ga-PSMA) has demonstrated increasing utility in the evaluation of prostatic carcinoma, it is essential to be aware of false-negative findings. Further subtype analyses of prostate cancer will be helpful in the understanding of the underlying reasons. We herein present a high-grade prostate adenocarcinoma, with metastatic lesions showing high 18F-labeled fluoro-2-deoxyglucose uptake instead of 68Ga-PSMA.
Conditions: Biochemically Recurrent Prostate Carcinoma; Metastatic Prostate Carcinoma; Prostate Adenocarcinoma; Prostate Carcinoma; PSA Level Greater Than Fifty; PSA Progression; Stage IV Prostate Cancer AJCC v8; Stage IVA Prostate Cancer AJCC v8; Stage IVB Pr ostate Cancer AJCC v8 Interventions: Procedure: Computed Tomography; Radiation: Gallium Ga 68-labeled PSMA-11; Procedure...