open access publication

Article, 2022

Prostate cancer metastasis mimicking appendicitis—A rare but important differential diagnosis in PET/CT imaging

Radiology Case Reports, ISSN 1930-0433, Volume 18, 1, Pages 266-270, 10.1016/j.radcr.2022.10.024

Contributors

Kühl, Johanne 0000-0003-3913-1131 (Corresponding author) [1] Buch-Olsen, Karen Middelbo 0000-0002-6456-2593 [1] [2] Elhakim, Mohammad Talal 0000-0002-2673-2352 [1] [2]

Affiliations

  1. [1] University of Southern Denmark
    2. [NORA names: SDU University of Southern Denmark; University; Denmark; Europe, EU; Nordic; OECD];
  2. [2] Odense University Hospital
    3. [NORA names: Region of Southern Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD]

Abstract

Prostate cancer most commonly metastasizes to lymph nodes, bones, the liver, and the lungs. Prostate cancer carcinomatosis with an affinity for the appendix is not well described in current literature and is usually reported with acute appendicitis as the primary presentation. A 65-year-old male with a history of recurrent prostate cancer presented with an increase in PSA value. 18F-PSMA-1007 PET/CT showed nodular tissue growth and increased PSMA uptake in the prostate, on the appendix, in the umbilicus, and in several intra- and extra pelvic lymph nodes. The patient had no symptomatic complaints at time of referral. Imaging findings of the appendix resembling characteristic findings of acute appendicitis raised doubts about the interpretation of these as inflammatory disease or peritoneal carcinomatosis secondary to prostate cancer. This case demonstrates the importance of correct differentiation between the 2 conditions based on imaging, clinical symptomatology, and patient history to provide proper care in time.

Keywords

PET/CT, PET/CT imaging, PSA, PSA values, PSMA uptake, acute appendicitis, affinity, appendicitis, appendix, bone, cancer, cancer metastasis, carcinomatosis, care, cases, clinical symptomatology, complaints, conditions, correct differentiation, diagnosis, differential diagnosis, differentiation, disease, findings, findings of acute appendicitis, growth, history, images, imaging findings, increase, increased PSMA uptake, inflammatory diseases, interpretation, intra-, literature, liver, lung, lymph nodes, male, metastasis, metastasize to lymph nodes, nodes, patient history, patients, pelvic lymph nodes, presentation, primary presentation, prostate, prostate cancer, prostate cancer metastasis, recurrent prostate cancer, referral, secondary to prostate cancer, symptomatic complaints, symptomatology, tissue growth, umbilicus, uptake, values

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