Prostate cancer metastasis to the rectal mucosa, a relatively rare metastatic site, leads to a higher clinical stage and poorer prognosis. A 65-year-old man with prostate cancer underwent 18 F-prostate-specific membrane antigen (PSMA) PET/CT for staging. Intense 18 F-PSMA uptake occurred at the primary lesion, bladder, adjacent seminal vesicle, and rectum. PET/CT imaging revealed increased homogeneous round activity of the rectal wall. The final diagnosis was prostate cancer metastasis to the rectal mucosa. This case suggested that 18 F-PSMA PET/CT may assist in locating rare metastases of prostate cancer, with potential value for early staging.
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