68Ga–Prostate-Specific Membrane Antigen–Avid Tubercular Lesions Mimicking Prostate Cancer Metastasis on Simultaneous Prostate-Specific Membrane Antigen PET/MRI

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68Ga–prostate-specific membrane antigen (PSMA) has gained increasing interest as a target molecule in imaging of prostate cancer because of its selective overexpression in local prostate cancer lesions and metastasis. We report a case of a 62-year-old man with raised serum prostate-specific antigen levels who presented for 68Ga-PSMA HBED-CC simultaneous PET/MRI for prostate cancer evaluation. A PSMA-nonavid PI-RADS 5 (Prostate Imaging—Reporting and Data System) lesion was confirmed as adenocarcinoma on histopathology. The PSMA-avid lesions were noted in the calvarium and lung, with the calvarial lesion confirmed to be of tubercular etiology on biopsy, and both lesions subsequently responded to antitubercular treatment.

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