Unexpected discovery of hepatic cancer via 68Ga-PSMA PET/CT in the staging of prostate cancer

PSMA PET/CT (prostate-specific membrane antigen-based positron emission tomography) measures the overexpression of PSMA with the highest sensitivity in prostate cancer, offering a feasible pathway for detecting primary tumors, metastasis, and recurrences. Several cases reported a PSMA uptake in other solid tumors including also cholangiocarcinoma, broadening its potential utility. Thus, PSMA PET/CT's primary value lies in enhancing prostate cancer diagnostics, but it also aids in detecting other malignancies. Here, we present the case report of an 82-year-old man initially diagnosed with high-risk prostate cancer with unusual PSMA accumulation in the liver at PSMA PET/CT, later identified as a cholangiocarcinoma.