Prostate-specific membrane antigen (PSMA) overexpression has been described in various malignancies. Hereby we present a case of a 69-year-old man simultaneously diagnosed with prostate cancer, esophageal adenocarcinoma, and HCC (hepatocellular carcinoma). 18F-FDG PET/CT showed pathological uptake in the esophageal adenocarcinoma and the primary prostate tumor, whereas 68Ga-PSMA-11 PET/CT performed for staging of the histopathologically confirmed prostate cancer revealed the primary tumor and significant uptake in the HCC. This finding is remarkable because the high physiological liver uptake of 68Ga-PSMA-11 may hamper the detection of small lesions.
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