Skip to main content
SpringerLink
Log in

Synchronous Pulmonary Malignancy Detected During PSMA Ligand PET/CT for Initial Staging of Prostate Cancer: a Case Report

  • Case Report
  • Published:
Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

We present a case of an 83-year-old man with underlying colorectal cancer who underwent a gallium-68 prostate specific membrane antigen-11 positron emission tomography/computed tomography (68 Ga-PSMA-11 PET/CT) for the initial staging of prostate cancer. PET / CT revealed two mildly PSMA-avid lung nodules without evidence of PSMA-avid nodal or bony metastasis. Subsequently, a wedge pulmonary resection was performed and the histopathology and immunohistochemistry of the nodules were consistent with synchronous primary lung cancer. Because differentiating synchronous primary lung cancer from pulmonary metastasis of prostate cancer can significantly affect treatment strategies and pulmonary metastasis rarely presents during initial staging of prostate cancer, synchronous primary lung cancer should be included in the differential diagnosis of pulmonary lesions in initial staging of 68 Ga-PSMA-11 PET/CT regardless of PSMA avidity. The lack of nodal or bony metastases also decreases the likelihood of lung metastasis, and a tissue diagnosis may be required.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data Availability

The data is available upon reasonable request to the corresponding author.

References

  1. Osman MM, Iravani A, Hicks RJ, Hofman MS. Detection of synchronous primary malignancies with (68)Ga-labeled prostate-specific membrane antigen PET/CT in patients with prostate cancer: frequency in 764 patients. J Nucl Med. 2017;58:1938–42.

    Article  CAS  PubMed  Google Scholar 

  2. Corvino A, Setola SV, Sandomenico F, Corvino F, Catalano O. Synchronous tumours detected during cancer patient staging: prevalence and patterns of occurrence in multidetector computed tomography. Pol J Radiol. 2020;85:261–70.

    Article  Google Scholar 

  3. de Galiza BF, Queiroz MA, Nunes RF, Costa LB, Zaniboni EC, Marin JFG, et al. Nonprostatic diseases on PSMA PET imaging: a spectrum of benign and malignant findings. Cancer Imaging. 2020;20:23.

    Article  Google Scholar 

  4. Van de Wiele C, Sathekge M, de Spiegeleer B, De Jonghe PJ, Debruyne PR, Borms M, et al. PSMA expression on neovasculature of solid tumors. Histol Histopathol. 2020;35:919–27.

    PubMed  Google Scholar 

  5. Van de Wiele C, Sathekge M, de Spiegeleer B, de Jonghe PJ, Beels L, Maes A. PSMA-targeting positron emission agents for imaging solid tumors other than non-prostate carcinoma: a systematic review. Int J Mol Sci. 2019;20:4886.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ozsoy O, Fioretta G, Ares C, Miralbell R. Incidental detection of synchronous primary tumours during staging workup for prostate cancer. Swiss Med Wkly. 2010;140:233–6.

    PubMed  Google Scholar 

  7. Bubendorf L, Schöpfer A, Wagner U, Sauter G, Moch H, Willi N, et al. Metastatic patterns of prostate cancer: an autopsy study of 1,589 patients. Hum Pathol. 2000;31:578–83.

    Article  CAS  PubMed  Google Scholar 

  8. Fabozzi SJ, Schellhammer PF. el-Mahdi AM Pulmonary metastases from prostate cancer. Cancer. 1995;75:2706–9.

    Article  CAS  PubMed  Google Scholar 

  9. Wu LX, Lei L, Zhu YC, Du KQ, Li XF, Chen HF, et al. A prostate cancer patient with isolated lung metastases: a case report. Transl Cancer Res. 2020;9:2064–8.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Perez PM, Hope TA, Behr SC, van Zante A, Small EJ, Flavell RR. Intertumoral heterogeneity of 18F-FDG and 68Ga-PSMA uptake in prostate cancer pulmonary metastases. Clin Nucl Med. 2019;44:28–32.

    Article  Google Scholar 

  11. Damjanovic J, Janssen JC, Furth C, Diederichs G, Walter T, Amthauer H, et al. 68 Ga-PSMA-PET/CT for the evaluation of pulmonary metastases and opacities in patients with prostate cancer. Cancer Imaging. 2018;18:20.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Pyka T, Weirich G, Einspieler I, Maurer T, Theisen J, Hatzichristodoulou G, et al. 68Ga-PSMA-HBED-CC PET for differential diagnosis of suggestive lung lesions in patients with prostate cancer. J Nucl Med. 2016;57:367–71.

    Article  CAS  PubMed  Google Scholar 

  13. Schmidt LH, Heitkötter B, Schulze AB, Schliemann C, Steinestel K, Trautmann M, et al. Prostate specific membrane antigen (PSMA) expression in non-small cell lung cancer. PLoS One. 2017;12:10.

    Google Scholar 

  14. Wang H long, Wang S shan, Song W hui, Pan Y, Yu H peng, Si T guo, et al. Expression of prostate-specific membrane antigen in lung cancer cells and tumor neovasculature endothelial cells and its clinical significance. PLoS One. 2015;10:5.

  15. Hangaard L, Jochumsen MR, Vendelbo MH, Bouchelouche K. Metastases from colorectal cancer avid on 68Ga-PSMA PET/CT. Clin Nucl Med. 2017;42:532–3.

    Article  PubMed  Google Scholar 

  16. Cuda TJ, Riddell AD, Liu C, Whitehall VL, Borowsky J, Wyld DK, et al. PET Imaging quantifying 68Ga-PSMA-11 uptake in metastatic colorectal cancer. J Nucl Med. 2020;61:1576–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge all the staffs of the Nuclear Medicine Unit, King Chulalongkorn Memorial Hospital.

Author information

Authors and Affiliations

  1. Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand

    Napisa Bunnag

  2. Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

    Napisa Bunnag, Jirarot Wongwijitsook & Sira Vachatimanont

  3. Nuclear Medicine Unit, King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathum Wan, Bangkok, Thailand

    Jirarot Wongwijitsook & Sira Vachatimanont

Authors
  1. Napisa Bunnag
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jirarot Wongwijitsook
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sira Vachatimanont
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Napisa Bunnag participated in the study conception, study design, and manuscript revision. Chirarot Wongwichitsuk participated in data acquisition, data analysis, and manuscript revision. Sira Vachatimanont participated in drafting of the manuscript and approval of the final content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sira Vachatimanont.

Ethics declarations

Conflict of Interest

Napisa Bunnag, Chirarot Wongwichitsuk, and Sira Vachatimanont declare no competing interests.

Ethical Approval

The present study was approved by the Institutional Review Board of the Faculty of Medicine, Chulalongkorn University (IRB number 0051/66), and with the 2013 Helsinki declaration and its later amendments or comparable ethical standards.

Consent to Participate

The informed consent requirement was waived by the Institutional Review Board of the Faculty of Medicine, Chulalongkorn University.

Consent for Publication

The institutional review board at our institution approved this retrospective study, and the requirement to obtain informed consent was waived.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bunnag, N., Wongwijitsook, J. & Vachatimanont, S. Synchronous Pulmonary Malignancy Detected During PSMA Ligand PET/CT for Initial Staging of Prostate Cancer: a Case Report. Nucl Med Mol Imaging 57, 287–290 (2023). https://doi.org/10.1007/s13139-023-00798-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13139-023-00798-2

Keywords

Search

Navigation