Paget bone disease demonstrated on ^sup 68^Ga-PSMA ligand PET/CT

• Published in: European journal of nuclear medicine and molecular imaging Vol. 43; no. 1; p. 195
• Main Authors: Artigas, C, Alexiou, J, Garcia, C, Wimana, Z, Otte, F-x, Gil, T, Van Velthoven, R, Flamen, P
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer Nature B.V 01.01.2016
• Subjects: Bone diseases; Case studies; Older people; Tomography
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-015-3236-x

We present the case of an 87-year-old man with a history of prostatic adenocarcinoma diagnosed in 2006 and initially treated locally with high intensity focused ultra-sound. An increase of prostate-specific antigen (PSA) values was detected recently and a positron emission/ computed tomography (PET/CT) investigation with the 68Ga-labelled prostate-specific membrane antigen (PSMA) ligand [Glu-NH-CO-NH-Lys(Ahx)-HBED-CC] was performed at our institution [1]. Apart from focal increased uptake in the prostatic bed, a non-expected overexpression of PSMA was found involving the proximal phalanx of the fourth finger of the left hand (a). On the bone scan performed at the time of initial diagnosis, 9 years ago (b), it appeared that an intense 99mTc-HDP uptake had already been described in the same location, involving the whole phalanx, with an image suggestive for bone Paget disease (PD) [2]. On physical examination the patient had a swollen and non-painful proximal phalanx with restricted finger motility. A plain X-ray of the hands was performed (c) confirming the diagnosis of monostotic PD of the phalanx [3].