Abstract
Prostate cancer (PCa) staging has advanced significantly with the emergence of prostate-specific
membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT).
However, PSMA-labeled radiotracers uptake is not exclusive to PCa, leading to potential
pitfalls. We report an unusual case of a 71-year-old man with high-risk PCa undergoing
initial staging with PET/CT using 18F-labeled PSMA (18F-PSMA), which revealed an unexpected uptake in a pleural nodular lesion. Given the
extreme rarity of PCa pleural metastases, an excisional biopsy of the lesion was performed.
Histopathological analysis confirmed the diagnosis of a pleural lobular capillary
hemangioma, a benign vascular tumor extremely rare in this location. This case represents
the first documented instance of PSMA radiopharmaceutical uptake in a pleural hemangioma,
expanding the spectrum of known PSMA PET/CT pitfalls. This finding underscores the
importance of histopathological confirmation for atypical PSMA PET/CT findings in
unusual locations, preventing incorrect staging and avoiding inappropriate therapeutic
decisions.
Keywords
18F-PSMA PET/CT - case report - pitfall - pleural hemangioma - prostate cancer
