Yip Alexander, Yap June
From the Department of Nuclear Medicine, Liverpool Hospital, Liverpool, New South Wales, Australia.
Clin Nucl Med. 2024 Jul 1;49(7):e346-e350. doi: 10.1097/RLU.0000000000005239. Epub 2024 Apr 30.
Metastatic prostate cancer to the appendicular skeleton is rare. We present an 86-year-old man with undiagnosed prostate cancer presenting with unilateral foot pain. CT and MRI demonstrated a sclerotic midfoot suggestive of an infiltrative process. In view of an elevated PSA, metastatic disease was suspected, and bone scan confirmed osteoblastically active pelvic and lower-limb skeletal lesions. Subsequent prostate biopsy confirmed prostate adenocarcinoma. Staging 68 Ga-PSMA PET/CT demonstrated PSMA-avid intraprostatic malignancy with pelvic and right lower-limb skeletal metastases. This is an unusual case of de novo 68 Ga-PSMA-avid metastatic prostate cancer with atypical lower-limb skeletal metastases presenting with foot pain.
转移性前列腺癌累及四肢骨骼较为罕见。我们报告一例86岁男性，患有未确诊的前列腺癌，表现为单侧足部疼痛。CT和MRI显示中足硬化，提示有浸润性病变。鉴于前列腺特异性抗原（PSA）升高，怀疑为转移性疾病，骨扫描证实骨盆和下肢骨骼有骨母细胞活性病变。随后的前列腺活检确诊为前列腺腺癌。68 Ga-PSMA PET/CT分期显示前列腺内有PSMA摄取阳性的恶性肿瘤，伴有骨盆和右下肢骨骼转移。这是一例罕见的新发68 Ga-PSMA摄取阳性的转移性前列腺癌，伴有非典型下肢骨骼转移并以足部疼痛为表现。
