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CC BY 4.0 · World J Nucl Med 2023; 22(01): 067-069
DOI: 10.1055/s-0042-1758805
Case Report

Not All Glittering Bone Lesions Are Gold: A Case of Sclerotic Bone Lesions with Elevated 68Ga PSMA and 99mTc HDP Uptake with No Signs of Malignancy

Morten Bentestuen
1   Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark
,
Maria Carlsen Elkjær
2   Department of Urology, Aalborg University Hospital, Aalborg, Denmark
,
Helle D. Zacho 
1   Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark
3   Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
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Abstract

Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography (68Ga PSMA PET/CT) outperforms CT and bone scintigraphy in terms of diagnostic accuracy for the primary staging of prostate cancer and has become widely used. However, 68Ga PSMA uptake is also encountered in nonprostatic tissue. We present a 63-year-old male with newly diagnosed high-risk prostate cancer who underwent bone scintigraphy with single-photon emission computed tomography/computed tomography (SPECT/CT), which showed inhomogeneous elevated uptake in sclerotic bone lesions in the pelvis. Likewise, 68Ga PSMA PET/CT revealed inhomogeneous uptake in the same areas. Subsequent biopsy revealed hyperplastic bone marrow without signs of malignancy. The patient underwent radical prostatectomy, and the prostate-specific antigen level dropped to less than 0.1 ng/mL.

Keywords

68Ga PSMA PET/CT - bone scan - prostate cancer - primary staging

Note

The patient was scanned and treated at Aalborg University Hospital, Aalborg, Denmark.


Authors' Contributions

Authors are credited in the presented order of authorship. Morten Bentestuen was responsible for the completion of the present case report, gathered data, drafted manuscripts and created all figures. Helle Damgaard Zacho supervised the process. Maria Carlsen Elkjær and Helle Damgaard Zacho revised drafts and accepted the final product.




Publication History

Article published online:
20 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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