Multimodal Management of Advanced Metastatic Prostate Cancer: Excellent Response Following Resection of Brain Metastasis and 177Lu-PSMA Therapy.

Divband, Ghasemali; Amini, Hamidreza; Saeidi Saedi, Hamid; Shahvarani, Seyed A; Sahafi, Pegah · Clin Nucl Med · 2026

case_report · Level V

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Abstract

A 68-year-old man with metastatic prostate adenocarcinoma was treated with androgen-deprivation therapy and chemotherapy. Restaging 68Ga-PSMA PET/CT revealed a PSMA-avid lesion in the left temporal lobe, which was treated with brain radiotherapy. Subsequent PSMA PET/CT showed brain lesion progression and skeletal metastases. He underwent brain lesion resection followed by 4 cycles of 177Lu-PSMA-617, achieving near-complete resolution of skeletal metastasis. This case highlights the importance of multimodal treatment, including 177Lu-PSMA, in managing brain metastasis in prostate cancer.

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