PSMA Expression Heterogeneity in Metastatic Prostate Carcinoma: A Case of Discordant Liver Metastases on 68 Ga PSMA PET/CT Showing Uptake on Post-Lu-177 PSMA Therapy Scan.
case_report · Level V
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- Record sourced from PubMed, PMID 41400443.
- Also identified by DOI 10.1097/RLU.0000000000006287.
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Abstract
We report a case of metastatic castration-resistant prostate carcinoma with discordant PSMA (prostate specific membrane antigen) expression- 68 Ga-PSMA PET/CT (positron emission tomography/computed tomography) showed PSMA-avid skeletal metastases but nonavid liver lesions. The patient received 177 Lu-PSMA-617 on compassionate grounds. Post-therapy imaging revealed radiotracer uptake in both skeletal and previously nonavid hepatic metastases, suggesting possible increased lesion amenability. This case highlights the dynamic nature of PSMA expression and the potential role of post-therapy scans in revealing responsive disease not visualized on baseline imaging.
Medical subject headings
- Positron Emission Tomography Computed Tomography
- Liver Neoplasms
- Antigens, Surface
- Glutamate Carboxypeptidase II
- Lutetium
- Prostatic Neoplasms
- Dipeptides
- Gene Expression Regulation, Neoplastic
- Heterocyclic Compounds, 1-Ring
- Edetic Acid