Unexpected 18 F-PSMA-1007 Uptake in a Colonic Diverticulum : A Benign Mimicker of Metastatic Prostate Cancer.

Zhang, Zeyu; Guo, Zhongqiu; Zuo, Changjing; Zhu, Lizhi; Cheng, Chao · Clin Nucl Med · 2026

case_report · Level V

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Abstract

A 68-year-old man with rising PSA (0.363 ng/mL) 6 years post-prostatectomy underwent 18 F-PSMA-1007 PET/CT. The scan revealed rib metastasis and an unexpected PSMA-avid focus in the ascending colon. Previous 68 Ga-PSMA and subsequent 18 F-FDG PET both showed no abnormal uptake in the ascending colon area. Colonoscopy confirmed an ascending colon diverticulum. This rare case demonstrates intense 18 F-PSMA-1007 uptake in a colonic diverticulum, likely attributable to PSMA expression by neovascular endothelium or inflammatory cells. Clinicians should consider colonic diverticulum in the differential diagnosis of PSMA-avid colonic lesions to prevent misdiagnosis.

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