Solitary Scapular Metastasis as the First Presentation of Prostate Adenocarcinoma Identified on 99mTc-MDP SPECT/CT

Cerebral and Muscular Metastases From Prostate Adenocarcinoma Initially Depicted by 177 Lu-PSMA SPECT/CT

ABSTRACT

Cerebral and muscular metastases from prostatic adenocarcinoma occur rarely. Patients who develop such metastatic pattern exhibit noticeable symptoms. Herein, we present a 68-year-old man diagnosed with metastatic castrate-resistant prostate cancer. The patient received multiple 177 Lu-PSMA cycles. After the last cycle, a posttreatment SPECT/CT suggested disease progression with uncommon metastatic pattern in the right temporal brain lobe and muscles. 68 Ga-PSMA PET/CT and brain MRI confirmed these findings. Surprisingly, the patient remained asymptomatic up until the conclusion of the follow-up, which lasted for 3 months. This case emphasizes the importance of posttreatment scintigraphic imaging when other biomarkers are inconclusive.

The Isolated Humeral Metastasis as the Initial Presentation of Renal Cell Carcinoma Revealed by 18 F-FDG PET/CT

ABSTRACT

Renal cell carcinoma (RCC) with isolated humeral metastasis as the initial presentation is rare. We reported FDG PET/CT findings of isolated humeral metastasis from RCC in a 63-year-old man with right upper arm pain as the initial presentation. The bone scanning in an outside hospital showed that the focus with increased uptake of the right humerus was possibly malignant. FDG PET/CT showed that the right humeral mass had intense activity, and there was an additional FDG lesion in the lower pole of the right kidney. The mass of the right humerus was later confirmed as humeral metastasis from RCC by pathological examination.