Isolated Adrenal Metastases of Castration-Resistant Prostate Cancer

Topal E., Has Simsek D., Vatansever S., Sanli Y., Kuyumcu S.

CLINICAL NUCLEAR MEDICINE, vol.49, no.1, 2024 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Editorial Material
  • Volume: 49 Issue: 1
  • Publication Date: 2024
  • Doi Number: 10.1097/rlu.0000000000004964
  • Journal Name: CLINICAL NUCLEAR MEDICINE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Keywords: 177Lu-PSMA, 68Ga-PSMA PET/CT, adrenal metastases, prostate cancer
  • Istanbul University Affiliated: Yes

Abstract

We present isolated bilateral adrenal metastases successfully treated with Lu-177-PSMA in a 66-year-old man diagnosed with castration-resistant prostate cancer. The patient had progression under chemotherapy as depicted by Ga-68-PSMA PET/CT showing intense bilateral PSMA uptake in the adrenal masses, and metastasis-directed therapies were considered as the first option for improving survival because the patient was oligometastatic. However, surgery and radiotherapy were not justifiable options due to the high risk of definitive adrenal insufficiency; therefore, the patient received 4 cycles of Lu-177-PSMA treatment. Ga-68-PSMA PET/CT showed near-complete response in bilateral adrenal metastases, and no sign of adrenal insufficiency was observed during follow-up.