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An unusual metastasis of prostate cancer detected with 68Ga-PSMA PET/CT imaging: Corpus spongiosum of the radix penis
Metástasis inusual de cáncer de próstata en el cuerpo esponjoso del pene detectada mediante PET/TC con 68Ga-PSMA
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Además, se evidenció captación del trazador en 2 lesiones en el cuerpo esponjoso de la base del pene como se observa en la imagen PET sagital (b), imágenes de fusión PET/TC sagital (c) y TC sagital (d). Las mismas lesiones de pene son fácilmente visibles en las imágenes axiales de PET (e), imágenes de fusión PET/TC axial (f) y TC axial (g).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "H. Asli Ayan, M. Zor, B. Yildiz, S. Bedir" "autores" => array:4 [ 0 => array:2 [ "nombre" => "H." "apellidos" => "Asli Ayan" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Zor" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "Yildiz" ] 3 => array:2 [ "nombre" => "S." 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(a) In addition, tracer uptake was noted in two lesions in the corpus spongiosum of the radix penis as seen in the sagittal PET (b), fused sagittal PET/CT (c), and sagittal CT (d) images. The same penile lesions are also easily seen in the axial images of PET (e), fused axial PET/CT (f), and axial CT (g).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The primary staging of prostate cancer is an important challenge for physicians. The advent of Gallium-68 prostate-specific membrane antigen positron emission tomography/computer tomography (<span class="elsevierStyleSup">68</span>Ga-PSMA PET/CT) has overcome many of these problems and has become the best available imaging tool in the evaluation of prostate cancer.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It is also very useful in the detection of unusual metastasis of prostate cancer like inguinal canal, distant nodes and gastric metastasis.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a> The diagnosis of these unusual metastatic sites have also been successfully documented with other tracers including <span class="elsevierStyleSup">11</span>C-Choline PET/CT.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Herein we present a rare case of prostate cancer with penile metastasis and its <span class="elsevierStyleSup">68</span>Ga-PSMA PET/CT findings. A 75-year-old male was admitted to our outpatient clinic with acute urinary retention. His medical history was uneventful. Digital rectal examination revealed a diffuse firm prostate. Serum prostate specific antigen (PSA) level was 13.41<span class="elsevierStyleHsp" style=""></span>ng/ml. He underwent 12-core transrectal ultrasound guided prostate biopsy. Histopathological examination revealed a Gleason 5+4 prostate cancer. He was referred for <span class="elsevierStyleSup">68</span>Ga-PSMA PET/CT for primary staging. A conventional <span class="elsevierStyleSup">68</span>Ge/<span class="elsevierStyleSup">68</span>Ga radionuclide generator (Eckert & Ziegler Radiopharma GmbH, Berlin, Germany) was used to elute <span class="elsevierStyleSup">68</span>Ga and then compounded with PSMA-HBED-CC (Rotem Industries Ltd, Mishor Yamin, Arava, Israel) according to the method described previously.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> It showed up primary disease in the prostate gland, multiple pelvic nodal involvement, a metastatic lesion on the right ischium, and interestingly two lesions in the corpus spongiosum of the radix penis (SUV max of 17.2 and 11.6) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). He underwent androgen deprivation therapy and is on first year follow-up.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Despite the rich blood supply to the penis, penile metastasis is a rare phenomenon. It was first described by Eberth in 1870 and since then nearly 500 cases have been reported in the English literature. The studies published to date reveal that the majority of metastatic penile lesions are secondary to urological system malignancies such as prostate and bladder. Clinical manifestations include penile masses or nodules (80%), malignant priapism (20–53%), hematuria, pain and urinary symptoms. Despite our patient being admitted with acute urinary retention, his presenting symptom was not associated with the metastatic penile lesion. Initially we thought that the metastatic lesion located on the corpus spongiosum may have caused the acute urinary retention, but cystoscopy revealed no obstruction in the urethra. Additionally, palliative transurethral prostate resection relieved his lower urinary tract symptoms. The metastatic lesion on the corpus spongiosum was diagnosed with <span class="elsevierStyleSup">68</span>Ga-PSMA PET/CT. In conclusion, one should keep in mind the possibility of this unusual site of metastasis of prostate cancer. In such conditions, <span class="elsevierStyleSup">68</span>Ga-PSMA PET/CT is a powerful tool assessing the extent of the disease.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Ayan HA, Zor M, Yıldız B, Bedir S. Metástasis inusual de cáncer de próstata en el cuerpo esponjoso del pene detectada mediante PET/TC con 68Ga-PSMA. Rev Esp Med Nucl Imagen Mol. 2019;38:256–257.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2263 "Ancho" => 2500 "Tamanyo" => 263755 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Whole body Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography maximum projection image shows uptake in the primary prostate lesion, multiple pelvic lymph nodes, right ischium, and penis. (a) In addition, tracer uptake was noted in two lesions in the corpus spongiosum of the radix penis as seen in the sagittal PET (b), fused sagittal PET/CT (c), and sagittal CT (d) images. The same penile lesions are also easily seen in the axial images of PET (e), fused axial PET/CT (f), and axial CT (g).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The diagnostic value of PET/CT imaging with the (68)Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Afshar-Oromieh" 1 => "E. Avtzi" 2 => "F.L. Giesel" 3 => "T. Holland-Letz" 4 => "H.G. Linhart" 5 => "M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 July | 11 | 1 | 12 |
| 2023 March | 3 | 2 | 5 |
| 2019 July | 3 | 0 | 3 |
