A Case of Penile Metastasis from Prostate Cancer, Identified by 68Ga-PSMA PET/CT, Mimicking Peyronie's Disease: A Diagnostic Challenge

Farid Gossili; Niels Christian Langkilde; Helle D Zacho

doi:10.3390/diagnostics13152509

A Case of Penile Metastasis from Prostate Cancer, Identified by ⁶⁸Ga-PSMA PET/CT, Mimicking Peyronie's Disease: A Diagnostic Challenge

Diagnostics (Basel). 2023 Jul 27;13(15):2509. doi: 10.3390/diagnostics13152509.

Authors

Farid Gossili^{1

2}, Niels Christian Langkilde³, Helle D Zacho^{1

2}

Affiliations

¹ Department of Nuclear Medicine, Clinical Cancer Research Center, Aalborg University Hospital, 9000 Aalborg, Denmark.
² Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark.
³ Department of Urology, Aalborg University Hospital, 9000 Aalborg, Denmark.

Abstract

A 70-year-old man with high-risk prostate cancer (PCa) received radiation therapy and androgen deprivation therapy (ADT). The patient developed penile tenderness, compatible with Peyronie's disease upon physical examination. An ultrasound revealed a matching hypoechoic plaque and a thrombus in the vena dorsalis profunda, which were treated with anticoagulants. A follow-up ultrasound showed no abnormalities. Despite the use of analgesics, the patient suffered from persistent pain, later accompanied by an increasing PSA level of up to 7.5 ng/mL, despite ADT. ⁶⁸Ga-PSMA PET/CT showed a PSMA uptake consistent with PCa penile metastasis. Due to severe pain and the presence of metastatic PCa, the patient was referred for penectomy. Histopathological analysis confirmed metastases originating from the PCa. This case underscores the importance of ⁶⁸Ga-PSMA PET/CT in diagnosing PCa metastases and vigilance towards urogenital symptoms as potential indicators of metastases, despite the rarity of penile metastases.

Keywords: 68Ga-PSMA PET/CT; Peyronie’s disease; penile metastases; prostate cancer.

Grants and funding

This research received no external funding.