Cerebral and Muscular Metastases From Prostate Adenocarcinoma Initially Depicted by 177 Lu-PSMA SPECT/CT.

Al-Ibraheem, Akram; Istatieh, Feras; Abdlkadir, Ahmed Saad; Shahait, Mohammed; Khreish, Fadi · Clin Nucl Med · 2024

case_report · Level V

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Abstract

Cerebral and muscular metastases from prostatic adenocarcinoma occur rarely. Patients who develop such metastatic pattern exhibit noticeable symptoms. Herein, we present a 68-year-old man diagnosed with metastatic castrate-resistant prostate cancer. The patient received multiple 177 Lu-PSMA cycles. After the last cycle, a posttreatment SPECT/CT suggested disease progression with uncommon metastatic pattern in the right temporal brain lobe and muscles. 68 Ga-PSMA PET/CT and brain MRI confirmed these findings. Surprisingly, the patient remained asymptomatic up until the conclusion of the follow-up, which lasted for 3 months. This case emphasizes the importance of posttreatment scintigraphic imaging when other biomarkers are inconclusive.

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