Prostate cancer may be the second most common tumor in man. affected in a particular circumstance mainly because of neoangiogenesis, and false positives emerged in renal cell cancer, differentiated thyroid cancer, glioblastoma, breast malignancy brain metastasis, and paravertebral schwannomas. Understanding the causes of false positive will further enhance the confidence of interpretating PSMA scans. has not yet fully elucidated. its folate hydrolase activity has been associated with prostate carcinogenesis.[5] Certainly its expression is directly proportional to Gleason score and hormone resistant in prostate ICG-001 inhibition cancer but expression can be lost in poorly-differentiated tumor cell. PSMA is also expressed in salivary glands, duodenal mucosa, subset of proximal renal tubular cells, and subpopulation of neuroendocrine cells in colonic crypts small intestine.[6] Silver em et al /em . also reported that renal cell carcinoma, bladder transitional cell carcinoma, ICG-001 inhibition and colonic adenocarcinoma cells do not exhibits PSMA expression however intratumoral and peritumoral capillary endothelial cells showed intense immunoreactivity.[6] Case reports of false-positive PSMA PET-CT have been published in renal cell cancer,[7] differentiated thyroid cancer,[8] glioblastoma,[9] breast cancer brain metastasis,[10] and paravertebral schwannomas[11] with expression limited to neovasculature endothelial cells in most. In our case, the patient had synchronous malignancies in the right ureter and prostate and with rising PSA (0.59 ng/ml) and short PSA doubling time ( 6 months), a more specific scan (68Ga-PSMA) was performed which showed positive left supraclavicular lymph node, nonetheless biopsy with IHC suggest metastatic urothelial carcinoma. GATA-3 is usually a sensitive and specific ICG-001 inhibition marker for urothelial carcinoma both in primary and nodal metastasis.[12] It expression is comparable to urothelial carcinoma associated markers CK7 and better than p63. CK20 is also positive in half of urothelial carcinoma. Because of suboptimal sensitivity of PSA for high-grade prostate carcinoma, PSAP IHC was used, but it was found negative. No further IHC such as PSMA was done due to financial constraints. In this case, most likely PSMA has been expressed on neovasculature of metastatic urothelial carcinoma cells and caused false-positive results on PET-CT. In our experience of over 150 cases of Ga-68 PSMA PET-CT since 2014, we have indeed seen PSMA expression in synchronous Rabbit Polyclonal to ARTS-1 mucinous adenocarcinoma colon and metastatic lymph nodes from parotid gland carcinoma in one of each case as well. CONCLUSION PSMA PET-CT has received tremendous attention in molecular imaging, especially for the diagnosis of recurrence in treated prostate cancer patients. Being a very sensitive test, its use has grown in recent years despite few known limitations. This case report further highlights its vigilant use in differentiating prostate carcinoma with other solid cancers. Quantification values may be a key factor for differentiating fake positive from accurate ones and really ICG-001 inhibition should be a subject of research for future years. Financial support and sponsorship Nil. Issues appealing A couple of no conflicts appealing. Sources 1. Jain S, Saxena S, Kumar A. Epidemiology of prostate cancers in India. Meta ICG-001 inhibition Gene. 2014;2:596C605. [PMC free of charge content] [PubMed] [Google Scholar] 2. Hamilton W, Clear DJ, Peters TJ, Circular AP. Clinical top features of prostate cancers before medical diagnosis: A population-based, case-control research. Br J Gen Pract. 2006;56:756C62. [PMC free of charge content] [PubMed] [Google Scholar] 3. Mease RC, Foss CA, Pomper MG. Family pet imaging in prostate cancers: Concentrate on prostate-specific membrane antigen. Curr Best Med Chem. 2013;13:951C62. [PMC free of charge content] [PubMed] [Google Scholar] 4. Rinker-Schaeffer CW, Hawkins AL, Su SL, Israeli RS, Griffin CA, Isaacs JT, et al. Localization and physical mapping from the prostate-specific membrane antigen (PSM) gene to individual chromosome 11. Genomics. 1995;30:105C8. [PubMed] [Google Scholar] 5. Yao V, Parwani A, Maier C, Heston WD, Bacich DJ. Average appearance of prostate-specific membrane antigen, a tissues differentiation antigen and folate hydrolase, facilitates prostate carcinogenesis. Cancers Res. 2008;68:9070C7. [PMC free of charge content] [PubMed] [Google Scholar] 6. Sterling silver DA, Pellicer I, Good WR, Heston WD, Cordon-Cardo C. Prostate-specific membrane antigen expression in malignant and regular individual tissues. Clin Cancers Res..