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Nuklearmedizin
DOI: 10.1055/a-2221-3220
Case Report

Incidental Finding of a Pancreatic Adenocarcinoma on [68Ga]Ga-PSMA-11 PET/CT in a mCRPC patient under [177Lu]Lu-PSMA-617 Radioligand Therapy

Giulia Santo
1   Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria (Ringgold ID: RIN27280)
2   Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, Catanzaro, Italy (Ringgold ID: RIN27280)
,
Gianpaolo Di Santo
1   Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria (Ringgold ID: RIN27280)
,
Bettina Zelger
3   Pathology, Medical University of Innsbruck, Innsbruck, Austria (Ringgold ID: RIN27280)
,
Irene Virgolini
1   Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria (Ringgold ID: RIN27280)
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Introduction

Prostate-specific membrane antigen (PSMA) is a transmembrane type II glycoprotein with folate hydrolase and neurocarboxypeptidase activity generally expressed by prostate epithelium and upregulated on the surface of prostatic adenocarcinoma (PCa) cells. Based on its exceptionally high level of PSMA expression by tumor cells, PSMA-based imaging as well as PSMA-based radioligand therapy (RLT) regimens have been introduced in the management of PCa patients. However, PSMA expression has also been demonstrated in the neovasculature of different solid tumor tissues. Even if the underlined mechanism is not completely understood, some preclinical data suggested that PSMA might be involved in cancer-related angiogenesis by degrading the extracellular matrix and participating in integrin signal transduction [1]. In this scenario, positron emission tomography/computed tomography (PET/CT) imaging by using Gallium-68 (68Ga) or Fluoro-18 (18F)-labeled PSMA ligands can play a role also in tumors beyond PCa. Although the growing interest in the diagnostic performance of PSMA ligands in different solid tumors, data remain limited for some subtypes [2].

Here we report the clinical case of a 68-year-old man under [177Lu]Lu-PSMA-617 therapy for metastatic castration-resistant prostate cancer (mCRPC) with the incidental detection of a pancreatic adenocarcinoma on the restaging [68Ga]Ga-PSMA-11 PET/CT.



Publication History

Received: 02 November 2023

Accepted: 27 November 2023

Article published online:
08 January 2024

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Uijen MJM, Derks YHW, Merkx RIJ. et al. PSMA radioligand therapy for solid tumors other than prostate cancer: background, opportunities, challenges, and first clinical reports. Eur J Nucl Med Mol Imaging 2021; 48 (13) 4350-4368
    CrossrefPubMedGoogle Scholar
  • 2 Vuijk FA, Kleiburg F, Noortman WA. et al. Prostate-Specific Membrane Antigen Targeted Pet/CT Imaging in Patients with Colon, Gastric and Pancreatic Cancer. Cancers (Basel) 2022; 14 (24) 6209
    CrossrefPubMedGoogle Scholar
  • 3 Ren H, Zhang H, Wang X. et al. Prostate-specific membrane antigen as a marker of pancreatic cancer cells. Med Oncol 2014; 31 (03) 857 DOI: 10.1007/s12032-014-0857-z. (PMID: 24477651)
    CrossrefPubMedGoogle Scholar
  • 4 Stock K, Steinestel K, Wiesch R. et al. Neovascular Prostate-Specific Membrane Antigen Expression Is Associated with Improved Overall Survival under Palliative Chemotherapy in Patients with Pancreatic Ductal Adenocarcinoma. Biomed Res Int 2017; 2017: 2847303
    CrossrefPubMedGoogle Scholar
  • 5 Krishnaraju VS, Kumar R, Mittal BR. et al. Differentiating benign and malignant pancreatic masses: Ga-68 PSMA PET/CT as a new diagnostic avenue. Eur Radiol 2021; 31 (04) 2199-2208 DOI: 10.1007/s00330-020-07318-2. (PMID: 33001304)
    CrossrefPubMedGoogle Scholar