Interesting Image

Isolated Castrate-resistant Prostate Cancer Metastasis to Both Adrenal Glands Detected on ⁶⁸Ga PSMA PET/CT

10.4274/mirt.galenos.2023.03780

• Osman Kanatsız
• Filiz Özülker
• Tamer Aydın
• Tamer Özülker

Received Date: 01.05.2022 Accepted Date: 15.02.2023 Mol Imaging Radionucl Ther 2023;32(3):244-246 PMID: 37870375

• Abstract
• Full Text
• Video - Image
• References
• 12
• 464

A 61-year-old male patient, who had undergone radical prostatectomy, underwent ⁶⁸Ga labeled prostate-specific membrane antigen (PSMA) positron emission tomography/computerized tomography (PET/CT) for evaluation of suspected biochemical recurrence of prostate cancer (PCa). PET/CT scan showed increased ⁶⁸Ga PSMA expressions in hypodense mass lesions in both adrenal gland localizations. An adrenal gland tru-cut biopsy was performed for the right side, which showed poor-differentiated carcinoma metastases associated with the patient’s high-grade PCa. As far as we could determine based on an extensive literature search, this is the second case in which isolated adrenal metastasis was detected by ⁶⁸Ga PSMA PET/CT study in a patient with PCa.

Keywords: Prostate cancer, 68Ga PSMA PET/CT, adrenal metastasis

Ethics

Informed Consent: Patient consent for the diagnostic study was obtained.

Peer-review: Internally peer-reviewed.

Authorship Contributions

Concept: O.K., F.Ö., Design: O.K., F.Ö., Data Collection or Processing: O.K., F.Ö., T.A., Analysis or Interpretation: O.K., F.Ö., T.A., T.Ö., Literature Search: O.K., F.Ö., T.Ö., Writing: O.K., F.Ö., T.Ö.

Conflict of Interest: No conflicts of interest were declared by the authors.

Financial Disclosure: The authors declare that this study has received no financial support.

Images

1. Bubendorf L, Schöpfer A, Wagner U, Sauter G, Moch H, Willi N, Gasser TC, Mihatsch MJ. Metastatic patterns of prostate cancer: an autopsy study of 1,589 patients. Hum Pathol 2000;31:578-583.
2. Vinjamoori AH, Jagannathan JP, Shinagare AB, Taplin ME, Oh WK, Van den Abbeele AD, Ramaiya NH. Atypical metastases from prostate cancer: 10-year experience at a single institution. AJR Am J Roentgenol 2012;199:367-72.
3. Gandaglia G, Abdollah F, Schiffmann J, Trudeau V, Shariat SF, Kim SP, Perrotte P, Montorsi F, Briganti A, Trinh QD, Karakiewicz PI, Sun M. Distribution of metastatic sites in patients with prostate cancer: A population-based analysis. Prostate 2014;74:210-216.
4. Ashrafi AN, Fay C, Yip W, de Freitas DM, Nabhani J, Aron M. Durable biochemical response following adrenal metastasectomy for oligometastatic castrate-resistant prostate cancer. Urol Case Rep 2020;32:101229.
5. Strele-Trieb P, Dunzinger A, Sonnberger M, Wolfsgruber J, Pichler R. Uptake of 68Ga-Prostate-Specific Membrane Antigen PET in Adrenal Gland: A Potential Pitfall. Clin Nucl Med 2018;43:50-51.
6. Demirci E, Sahin OE, Ocak M, Akovali B, Nematyazar J, Kabasakal L. Normal distribution pattern and physiological variants of 68Ga-PSMA-11 PET/CT imaging. Nucl Med Commun 2016;37:1169-1179.
7. Law WP, Fiumara F, Fong W, Miles KA. Gallium-68 PSMA uptake in adrenal adenoma. J Med Imaging Radiat Oncol 2016;60:514-517.
8. Crowley MJ, Scognamiglio T, Liu YF, Kleiman DA, Beninato T, Aronova A, Liu H, Jhanwar YS, Molina A, Tagawa ST, Bander NH, Zarnegar R, Elemento O, Fahey TJ 3rd. Prostate-Specific Membrane Antigen Is a Potential Antiangiogenic Target in Adrenocortical Carcinoma. J Clin Endocrinol Metab 2016;101:981-987.
9. Arora S, Damle NA, Aggarwal S, Passah A, Behera A, Arora G, Bal C, Tripathi M. Prostate-Specific Membrane Antigen Expression in Adrenocortical Carcinoma on 68Ga-Prostate-Specific Membrane Antigen PET/CT. Clin Nucl Med 2018;43:449-451.
10. Ribeiro AMB, Lima ENP, Garcia D, Bezerra SM. Single Adrenal Metastasis From Prostate Cancer Detected by 68Ga-PSMA PET/CT and Confirmed by Biopsy: A Case Report. Clin Nucl Med 2022;47:61-62.