AUTHOR=Nearchou Marina , Georgiou Elizabeth , Vrachimis Alexis , Ferentinos Konstantinos , Strouthos Iosif 

TITLE=Case Report: Post-traumatic splenosis and potential pitfall for PSMA-PET

JOURNAL=Frontiers in Nuclear Medicine

VOLUME=Volume 3 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/nuclear-medicine/articles/10.3389/fnume.2023.1319952

DOI=10.3389/fnume.2023.1319952

ISSN=2673-8880

ABSTRACT=Background: 18F-prostate specific membrane antigen (PSMA) PET is fast becoming the goldstandard in prostate cancer, both in staging of intermediate-/high-risk and in re-staging patients with biochemical failure. Several pitfalls of 18F-PSMA PET have been reported and we report, to our best of knowledge, for the first time, a case which could have been falsely diagnosed as peritoneal spread.Case Presentation: A 67-year-old patient with high-risk prostate cancer underwent staging with 18F-PSMA-1007 PET/CT (abbrev. PSMA-PET/CT). PSMA PET/CT revealed the histologically confirmed prostatic malignancy in the peripheral zone left. Unexpectedly, additional multiple highly PSMA-expressing intraabdominal formations were discovered. Based on apparent anatomic asplenia and a history of traumatic splenic rapture during childhood, the suspicion of post-traumatic splenosis was raised. For further non-invasive evaluation, a C-99 sulphur colloid scintigraphy with SPECT was conducted, confirming the presence of multiple functional ectopic splenic tissue. This is, to our best of knowledge, the first case utilising 18F-PSMA-1007 PET/CT and 99mTc-sulphur colloid SPECT to detect intraabdominal splenosis, highlighting the high potential of nuclear medicine in such trivial cases.