Ga-PSMA PET is a rapidly evolving imaging modality for whole-body staging of prostate cancer. We report a case of a 70-year-old man with mildly elevated prostate-specific antigen (8.1 μg/L) and clinical suspicion of prostate cancer (osteoblastic metastases on radionuclide bone scan) who was referred for Ga-PSMA PET/CT for primary staging. Multiple Ga-PSMA-avid skeletal foci, mostly associated with lytic changes on low-dose CT, as well as hepatic foci of avid Ga-PSMA uptake, were identified. No abnormal focus of avid Ga-PSMA uptake was identified in the prostate. On histopathological examination, the liver lesion proved to be combined hepatocellular cholangiocarcinoma.
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