We present a 74-year-old man with a history of very high-risk prostate cancer (Gleason score: 5+4 in 11 of 14 cores) who was referred for initial staging with 99mTc-HYNIC-PSMA. The scan was reported as miT2m N2(REI, ROB) M1b(uni) M1c(skin?), PRIMARY score: 4, PSMA expression score: 1-3. We incidentally discovered increased uptake in the left skull region on whole-body images. Subsequent SPECT/CT imaging localized this uptake to a subcutaneous nodule in the scalp, which pathologic analysis confirmed to be a neurofibroma. Several lesions of neurological origin may exhibit significant PSMA avidity, which is reviewed here.
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