68Ga-DOTATOC and 68Ga-PSMA PET/CT Unmasked a Case of Prostate Cancer With Neuroendocrine Differentiation

A bedridden 90-year-old man with fever and elevated prostate-specific antigen (PSA) (49 ng/mL) was referred for differentiation between infection and tumor. F-FDG PET/CT was negative for infection, but Ga-PSMA PET/CT showed multiple lesions in prostate gland with infiltration to bladder wall and sem...

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Bibliographic Details
Published inClinical nuclear medicine Vol. 41; no. 12; p. 959
Main Authors Chen, Sirong, Cheung, Shing Kee, Wong, Ka-Nin, Wong, Kwok Kee, Ho, Chi-Lai
Format Journal Article
LanguageEnglish
Published United States 01.12.2016
Subjects
Aged, 80 and over
Humans
Male
Neuroendocrine Tumors - diagnostic imaging
Octreotide - analogs & derivatives
Organometallic Compounds
Positron Emission Tomography Computed Tomography
Prostatic Neoplasms - diagnostic imaging
Radiopharmaceuticals
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Summary:A bedridden 90-year-old man with fever and elevated prostate-specific antigen (PSA) (49 ng/mL) was referred for differentiation between infection and tumor. F-FDG PET/CT was negative for infection, but Ga-PSMA PET/CT showed multiple lesions in prostate gland with infiltration to bladder wall and seminal vesicle, consistent with locally advanced prostate cancer. The lesion with the highest Ga-PSMA uptake was strongly avid for Ga-DOTATOC, suggesting neuroendocrine tumor differentiation. After hormonal therapy, PSA normalized, but chromogranin-A increased (from 251 to 398 ng/mL), inferring progression of neuroendocrine tumor differentiation. Advanced prostate cancer may require investigation for pathological neuroendocrine transformation, although PSA may suggest improvement.
ISSN:1536-0229
DOI:10.1097/RLU.0000000000001419