Brain and Spinal Leptomeningeal Metastases in Prostate Cancer Detected by PSMA PET and MRI Fusion.
case_report · Level V
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- Record sourced from PubMed, PMID 41771034.
- Also identified by DOI 10.1097/RLU.0000000000006328 and PMC identifier 12947911.
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Abstract
A 66-year-old man with metastatic castration-resistant prostate adenocarcinoma experienced a rising PSA after multiple systemic therapies and radiation therapy to the cervical and thoracic spine for bone metastases. F-18 piflufolastat (Pylarify) PSMA PET/CT demonstrated widespread metastases, involving bones, lungs, mediastinal and hilar lymph nodes, liver, and intracranial and intraspinal sites. He subsequently developed worsening neurological symptoms. Brain MRI fused with PSMA PET revealed numerous radiotracer-avid scattered leptomeningeal enhancing foci intracranially. Cervical spine MRI fused with PSMA PET demonstrated multifocal radiotracer-avid intradural, extramedullary enhancing lesions. Biopsy of cervical intradural lesions confirmed metastatic prostate carcinoma.
Medical subject headings
- Magnetic Resonance Imaging
- Prostatic Neoplasms
- Meningeal Neoplasms
- Brain Neoplasms
- Positron Emission Tomography Computed Tomography
- Positron-Emission Tomography
- Antigens, Surface
- Multimodal Imaging
- Glutamate Carboxypeptidase II