Uncovering Hidden Metastases at Unusual Site: Emphasizing the Role of 177Lu-PSMA Posttherapy Scan in Detecting Rare Foot Metastasis in mCRPC

Clin Nucl Med. 2025 Feb 1;50(2):e118-e119. doi: 10.1097/RLU.0000000000005592.

Abstract

Prostate cancer frequently metastasizes to bones; however, the detection of metastases can be challenging in rare locations. We present the case of a 76-year-old man with metastatic castration-resistant prostate cancer with lymph nodal and skeletal metastases who underwent 177Lu-prostate-specific membrane antigen (PSMA) therapy. Initial 18F-PSMA PET/CT scan acquired until the midthigh failed to identify metastases in the foot, but posttherapy 177Lu-PSMA scan revealed the presence of metastases in the navicular and cuboid bones of the right foot, which is a very rare finding. This case highlights the limitations of standard PSMA PET/CT acquisition protocol and incremental value of whole-body posttherapy scan.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / radiotherapy
  • Bone Neoplasms / secondary
  • Foot / diagnostic imaging
  • Foot / pathology
  • Humans
  • Lutetium
  • Male
  • Neoplasm Metastasis
  • Positron Emission Tomography Computed Tomography*
  • Prostatic Neoplasms, Castration-Resistant* / diagnostic imaging
  • Prostatic Neoplasms, Castration-Resistant* / pathology
  • Prostatic Neoplasms, Castration-Resistant* / radiotherapy

Substances

  • Lutetium