More than the prostate: Intrapancreatic accessory spleen and papillary thyroid cancer detected with 18F-PSMA PET/CT.

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More than the prostate: Intrapancreatic accessory spleen and papillary thyroid cancer detected with 18F-PSMA PET/CT.

Hell J Nucl Med. 2018 Jul 12;:

Authors: Singh D, Horneman R, Nagra NK

Abstract
OBJECTIVE: Prostate specific membrane antigen (PSMA) positron emission tomography diagnostic computed tomography (PET/CT) is gaining an increasing role in the staging of prostate cancer and restaging in cases of biochemical recurrence. Our understanding of PSMA affinity for incidental pathological and non-pathological entities is also maturing although certain cases do present as diagnostic and management dilemmas.
SUBJECT AND METHODS: We present a case of a 55 years old man with prostate adenocarcinoma, with incidentally found pancreatic and thyroid lesions showing PSMA avidity.
RESULTS: We were able to utilize a heat damaged red blood cell single photon emission tomography (SPET)/CT scan and ultrasound guided fine needle aspiration (FNA) to accurately diagnose co-existent thyroid papillary carcinoma and intra-pancreatic accessory spleen (IPAS) tissue, respectively. The patient avoided invasive pancreatic tissue sampling and subsequent staging with fluorine-18 fluorodeoxyglucose (18F-FDG) PET/CT.
CONCLUSION: This is the first case to our knowledge describing both such lesions in one patient and the first case describing the use of 2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL)-PSMA PET/CT to detect IPAS. Furthermore we highlight the value of nuclear medicine diagnostic work up in complex cases.

PMID: 30006647 [PubMed - as supplied by publisher]

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