Solitary testicular metastasis from prostate adenocarcinoma revealed by F-18-fluorocholine PET/CT

With the development of new PET tracers, nuclear medicine has become a central element in the search for prostate cancer recurrence. A 75-year-old patient followed for a prostate adenocarcinoma was referred to our center for biological recurrence, with a gradual rise of prostatic specific antigen (PSA). A pelvic MRI and F-18-fluorocholine PET/CT were performed, both showing no strong evidence of local recurrence. This last examination however revealed an intense pathological radiotracer uptake only in the left testicle. After performing a complementary ultrasound imaging, orchiectomy revealed a metastatic testicular localization of the prostatic adenocarcinoma. PSA control after surgery had normalized. This case emphasizes one of the unusual presentations of metastatic prostatic disease to be aware of. (C) 2019 Elsevier Masson SAS. All rights reserved.