Hod Nir, Shrem Noa Shani, Levin Daniel
From the Institute of Nuclear Medicine and Molecular Imaging.
the Oncology Department, Soroka University Medical Center, Affiliated With the Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel.
Clin Nucl Med. 2025 Apr 1;50(4):e241-e244. doi: 10.1097/RLU.0000000000005616. Epub 2024 Dec 3.
We describe a rare case of metastatic prostate carcinoma to the heel. Bone scintigraphy revealed high uptake simulating fractures. Standard PSMA PET/CT was negative. As PSA elevated, extended field-of-view PET/CT revealed ankle uptake with virtually identical spatial distribution and intensity of both tracers. Histopathology confirmed ankle metastases of prostate carcinoma, which retrospectively was the inaugural manifestation of the metastatic skeletal disease. This case highlights the need to consider peripheral limb bone metastases in patients with biochemical recurrence. In case of focal symptoms or unexplained bone scan findings, the PSMA acquisition coverage should be extended to include the respective body part.
我们描述了一例罕见的前列腺癌转移至足跟的病例。骨闪烁显像显示摄取增高，类似骨折表现。标准的前列腺特异性膜抗原（PSMA）正电子发射断层显像/计算机断层扫描（PET/CT）结果为阴性。由于前列腺特异抗原（PSA）升高，扩大视野的PET/CT显示踝关节有摄取，两种示踪剂的空间分布和强度几乎相同。组织病理学证实为前列腺癌踝关节转移，回顾性分析这是转移性骨骼疾病的首发表现。该病例强调了在生化复发患者中需考虑外周肢体骨转移。对于有局部症状或不明原因的骨扫描结果的情况，应扩大PSMA采集范围以包括相应身体部位。
