Abstract
A 64-year-old man with history of prostate adenocarcinoma underwent radical prostatectomy in 2003. He remained with undetectable prostate-specific antigen (PSA) levels until 2014, when he then presented rising serum PSA levels and performed a Tc-MDP bone scan that was negative for metastases. In August 2015, his PSA was 4.89 ng/dL, and restaging images with pelvic MR and F-FDG PET/CT were both negative. Therefore, the patient underwent a Ga-PSMA PET/CT that showed marked tracer uptake in a single mediastinal lymph node. Histopathology demonstrated metastatic adenocarcinoma secondary to prostate cancer, altering patient management to hormone therapy instead of pelvic radiotherapy.
MeSH terms
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Adenocarcinoma / diagnostic imaging*
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Adenocarcinoma / secondary
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Antigens, Surface
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Fluorodeoxyglucose F18
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Gallium Radioisotopes
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Glutamate Carboxypeptidase II
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Humans
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Lymph Nodes / diagnostic imaging*
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Lymphatic Metastasis / diagnostic imaging*
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Magnetic Resonance Imaging
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Male
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Mediastinum
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Middle Aged
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Positron Emission Tomography Computed Tomography
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Prostate-Specific Antigen / blood
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Prostatectomy
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Prostatic Neoplasms / blood
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Prostatic Neoplasms / diagnostic imaging*
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Prostatic Neoplasms / pathology
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Prostatic Neoplasms / surgery
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Radiopharmaceuticals
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Technetium Tc 99m Medronate
Substances
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Antigens, Surface
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Gallium Radioisotopes
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Radiopharmaceuticals
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Fluorodeoxyglucose F18
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FOLH1 protein, human
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Glutamate Carboxypeptidase II
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Prostate-Specific Antigen
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Technetium Tc 99m Medronate