Detection of Diffuse Peritoneal and Omental Metastases From Prostate Cancer With 18F-PSMA-1007 PET/CT

Abstract

Diffuse peritoneal and omental infiltration of prostate cancer detected by 18 F-PSMA-1007 PET/CT was rarely reported. We report a case of an 80-year-old man who was suspected of prostate carcinoma metastasis and underwent 18 F-PSMA-1007 PET/CT for restaging the disease. PET/CT imaging presented intense tracer uptake in the prostate gland, multiple lymph nodes, and bones. Interestingly, we found extremely increased radioactive uptake of diffuse peritoneum and omentum on 18 F-PSMA-1007 PET/CT images, which are very rare metastatic sites for prostate cancer.

Peritoneal Carcinomatosis From Metastatic Prostate Cancer Identified on 68Ga-Prostate-Specific Membrane Antigen PET/CT

“…It has been proposed that surgical intervention could cause iatrogenic spread, leading to peritoneal seeding. 11,12,15 However, in this case, the patient did not undergo surgery. Cases of patients developing peritoneal metastases without prior surgical intervention have also been reported.…”

“…The mechanism of peritoneal metastasis is poorly understood. It has been proposed that surgical intervention could cause iatrogenic spread, leading to peritoneal seeding 11,12,15 . However, in this case, the patient did not undergo surgery.…”

“…2 To date, only a few cases of isolated peritoneal metastasis from prostate cancer have been described in the literature. [3][4][5][6][7][8][9][10][11][12] Rapoport and Omenn 13 performed autopsies on 523 prostate cancer patients and found only 13 cases of isolated peritoneal metastases. Another postmortem study of 176 patients reported only 5 cases of peritoneal involvement.…”

“…Peritoneal metastasis is extremely uncommon in prostate cancer cases, particularly without osseous involvement, and presents a poor prognosis 2. To date, only a few cases of isolated peritoneal metastasis from prostate cancer have been described in the literature [3][4][5][6][7][8][9][10][11][12]. Rapoport and Omenn 13 performed autopsies on 523 prostate cancer patients and found only 13 cases of isolated peritoneal metastases.…”

Peritoneal Metastases From Prostate Carcinoma Treated With 177Lu-PSMA-I&T

“…He already presented with omental metastases in 2018, without any other metastases. Omental and peritoneal metastases of prostate cancer positive on PSMA PET have been reported before 4–6 . As far as we know, only one patient with omental metastases treated with 177 Lu-PSMA has been described before 7 .…”