Prostate cancer cardiac metastasis detected on serial imaging with [⁶⁸Ga] PSMA-11 PET/CT

Excerpt

A 78-year-old man with Gleason 4+4 prostate cancer (PCa) initially treated with external beam radiation was imaged with Gallium-68 [ ⁶⁸Ga] prostate-specific membrane antigen (PSMA)-11 (HBED-CC- PSMA) positron emission tomography (PET)/computed tomography (CT) to evaluate biochemical recurrence with serum PSA of 2.5ng/mL. In addition to locally recurrent tumor involving the seminal vesicles (not shown), maximum intensity projection (a), axial PET (b), and fused axial PET/CT (c) demonstrated a PSMA-avid lesion involving the right atrium with a maximum standardized uptake value (SUVmax) of 2.7. On follow-up imaging at 4 months (d–f) and 8 months (g–i), the lesion SUVmax increased from 3.6 to 11.3. Echocardiography confirmed a right atrial mass. Endomyocardial biopsy was performed, and pathology was consistent with prostate adenocarcinoma which resulted in treatment escalation with systemic chemotherapy. …