• Hongguang Zhao, Yinghua Li, Sen Hou, Yuyin Dai, Chenghe Lin, and Songbai Xu.
• Department of Nuclear Medicine.
• Medicine (Baltimore). 2020 Oct 9; 99 (41): e22486.

RationaleProstate-specific membrane antigen positron emission tomography-computed tomography (F-PSMA-1007 PET/CT) imaging is an emerging method for the diagnosis of prostate cancer (PC), but its efficiency in detecting other accompanying diseases has rarely been investigated.Patient ConcernsA 77-year-old man presented with a complaint of bone pain throughout his entire body lasting for 2 weeks. Routine preoperative whole-body bone scanning revealed multiple osteogenic metastases. His alpha-fetoprotein and prostate-specific antigen levels were 108.2 ng/mL and 53.32 ng/mL, respectively. F-PSMA-1007 PET/CT imaging revealed high tracer uptake in the primary lesion in the liver and the peripheral zone of the prostate.DiagnosesDue to the results from imaging and pathological examinations, a diagnosis of PC with multiple bone metastases accompanied by primary hepatocellular carcinoma was made.InterventionsTaking into consideration the patient's age, interventional therapy was performed for the liver lesion, whereas the prostate and bone lesions were treated with endocrine therapy.OutcomesThe patient recovered well and was discharged uneventfully postoperatively. The patient was also doing well at the 6-month follow-up.LessonsPSMA-PET/CT imaging results must be interpreted cautiously when the uptake of PSMA increases in a single lesion instead of the most common sites of PC metastasis. Pathological examination of the suspected lesions is also recommended.

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