{"title":"Orbital and brain metastases on <sup>68</sup>Ga-PSMA PET/CT in a patient with prostate carcinoma refractory to <sup>177</sup>Lu-PSMA and <sup>225</sup>Ac-PSMA therapy.","authors":"Ashwin Singh Parihar, Kunal Ramesh Chandekar, Harpreet Singh, Ashwani Sood, Bhagwant Rai Mittal","doi":"10.22038/AOJNMB.2020.50820.1347","DOIUrl":null,"url":null,"abstract":"<p><p>We present a case of metastatic prostate cancer with rare metastases involving the brain and orbit, in addition to liver, skeletal and nodal metastases. The patient had undergone prior hormonal therapy and chemotherapy and had disease progression despite 2 cycles of <sup>177</sup>Lu-Prostate specific membrane antigen (<sup>177</sup>Lu-PSMA) based radioligand therapy. He had a partial response after 2 cycles of <sup>225</sup>Ac-PSMA based targeted alpha therapy, as demonstrated on the <sup>68</sup>Ga-PSMA PET/CT study. However, the patient had disease progression at the end of 4 cycles of <sup>225</sup>Ac-PSMA therapy, evident by rising prostate specific antigen levels and imaging findings. The end of treatment <sup>68</sup>Ga-PSMA PET/CT showed additional sites of metastases in the orbit and brain apart from overall disease progression. These are rare sites of distant spread in prostate cancer and require urgent evaluation and local treatment to prevent potential complications. The importance of detection of metastatic sites in closed cavities is because of the requirement for urgent intervention to avoid compression related complications.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701233/pdf/AOJNMB-9-67.pdf","citationCount":"11","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia Oceania Journal of Nuclear Medicine and Biology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22038/AOJNMB.2020.50820.1347","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 11
Abstract
We present a case of metastatic prostate cancer with rare metastases involving the brain and orbit, in addition to liver, skeletal and nodal metastases. The patient had undergone prior hormonal therapy and chemotherapy and had disease progression despite 2 cycles of 177Lu-Prostate specific membrane antigen (177Lu-PSMA) based radioligand therapy. He had a partial response after 2 cycles of 225Ac-PSMA based targeted alpha therapy, as demonstrated on the 68Ga-PSMA PET/CT study. However, the patient had disease progression at the end of 4 cycles of 225Ac-PSMA therapy, evident by rising prostate specific antigen levels and imaging findings. The end of treatment 68Ga-PSMA PET/CT showed additional sites of metastases in the orbit and brain apart from overall disease progression. These are rare sites of distant spread in prostate cancer and require urgent evaluation and local treatment to prevent potential complications. The importance of detection of metastatic sites in closed cavities is because of the requirement for urgent intervention to avoid compression related complications.