Abdominal Splenosis Mimicking Peritoneal Spread of Prostate Adenocarcinoma in 68Ga- PSMA PET/CT- A Case Report

Ron Y, Kesler M, Lerman H and Even-Sapir E

Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, Israel

^*Correspondance to: Ron Y 

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Abstract:

Background: ⁶⁸Ga-labeled prostate-specific membrane antigen ligand (⁶⁸Ga-PSMA) PET/CT has become a routine in our department for imaging patients with prostate cancer, staging of medium and high-risk patients, assessment of biochemical failure and planning of ¹⁷⁷Lu-PSMA therapy. Data accumulated exposes us to potential pitfalls in interpretation of ⁶⁸Ga-PSMA PET/CT studies. We report a case of a patient with potential misinterpretation of peritoneal spread.Case
Presentation: A 69-years-old man patient with prostate adenocarcinoma Gleason 9 underwent ⁶⁸Ga-PSMA PET/CT for disease extent assessment. Multiple soft tissue masses accumulating the tracer were detected in the left subdiaphragmatic area, anterior abdomen adjacent to the abdominal wall and on the bowel serosa presenting as abdominal metastatic spread. However, the spleen was not identified in its usual anatomical place. We approached the patient revealing that he had a post-traumatic splenectomy two decades earlier. ^99mTc-labeled heat-damaged red blood cells ^(99mTcdRBCs) SPECT/CT study confirmed our interpretation of ⁶⁸Ga-PSMA PET/CT as identifying physiological tracer uptake in abdominal splenosis rather than metastatic spread.Conclusion: Splenosis and not metastasis as the cause for abdominal lesions showing increased ⁶⁸Ga-PSMA uptake, should be considered in a patient with a previous history of abdominal trauma or splenectomy where spleen is not identified in its normal bed. Correlation with ^99mTc-dRBCs scan may assist in localizing ectopic splenic tissue sites.

Keywords:

PET; Prostate adenocarcinoma; ⁶⁸Ga-PSMA; Splenosis

Cite the Article:

Ron Y, Kesler M, Lerman H, Even-Sapir E. Abdominal Splenosis Mimicking Peritoneal Spread of Prostate Adenocarcinoma in 68Ga- PSMA PET/ CT- A Case Report. Ann Clin Case Rep. 2018; 3: 1520.