Atypical Metastases from Prostate Cancer: Alpha-Methylacyl-Coenzyme A Racemase (AMACR) as a Potential Molecular Target in Prostate-Specific Membrane Antigen-Negative Prostate Adenocarcinoma
Prostate cancer (PCa) is a high-prevalence disease usually characterized by metastatic spread to the pelvic lymph nodes and bones and the development of visceral metastases only in the late stages of disease. Positron Emission Tomography (PET) plays a key role in the detection of PCa metastases. Sev...
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2024-12-01
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| author | Ilham Badrane Angelo Castello Matteo Brunelli Corrado Cittanti Sara Adamantiadis Ilaria Bagni Noemi Mindicini Federica Lancia Massimo Castellani Licia Uccelli Mirco Bartolomei Luca Urso |
| author_facet | Ilham Badrane Angelo Castello Matteo Brunelli Corrado Cittanti Sara Adamantiadis Ilaria Bagni Noemi Mindicini Federica Lancia Massimo Castellani Licia Uccelli Mirco Bartolomei Luca Urso |
| author_sort | Ilham Badrane |
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| description | Prostate cancer (PCa) is a high-prevalence disease usually characterized by metastatic spread to the pelvic lymph nodes and bones and the development of visceral metastases only in the late stages of disease. Positron Emission Tomography (PET) plays a key role in the detection of PCa metastases. Several PET radiotracers are used in PCa patients according to the stage and pathological features of the disease, in particular <sup>68</sup>Ga/<sup>18</sup>F-prostate-specific membrane antigen (PSMA) ligands. Moreover, 2-deoxy-2-[18F]fluoro-D-glucose <sup>18</sup>F-FDG PET usually shows metastases in the late stages of disease, when dedifferentiated neoplastic clones lose PSMA expression. In some cases, PCa patients may present atypical sites of metastases, with uncommon appearance at PET imaging with different radiotracers. We present the case of a patient with biochemical recurrence of PCa (ISUP Grade Group IV; PSA 4.7 ng/mL) showing atypical sites of metastases (the testis and multiple lung nodules) with absent PSMA expression and high [<sup>18</sup>F]FDG avidity. The patient showed diffuse positivity to alpha-methylacyl-coenzyme A racemase (AMACR). Moreover, a literature review was performed by collecting cases of PCa patients with atypical metastatic spread detected via PET imaging, with the aim of highlighting the relationship between atypical sites of metastases, imaging presentation, and pathology findings. |
| format | Article |
| id | doaj-art-cf2f18487d164ee38d092d951ec1c679 |
| institution | Kabale University |
| issn | 2218-273X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomolecules |
| spelling | doaj-art-cf2f18487d164ee38d092d951ec1c6792025-01-24T13:24:52ZengMDPI AGBiomolecules2218-273X2024-12-011511710.3390/biom15010017Atypical Metastases from Prostate Cancer: Alpha-Methylacyl-Coenzyme A Racemase (AMACR) as a Potential Molecular Target in Prostate-Specific Membrane Antigen-Negative Prostate AdenocarcinomaIlham Badrane0Angelo Castello1Matteo Brunelli2Corrado Cittanti3Sara Adamantiadis4Ilaria Bagni5Noemi Mindicini6Federica Lancia7Massimo Castellani8Licia Uccelli9Mirco Bartolomei10Luca Urso11Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, ItalyNuclear Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Pathology and Diagnostic Health, University of Verona, 37100 Verona, ItalyDepartment of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, ItalyDepartment of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, ItalyAnatomic Pathology Unit, University Hospital of Ferrara, 44124 Ferrara, ItalyOncology Unit, University Hospital of Ferrara, 44124 Ferrara, ItalyOncology Unit, University Hospital of Ferrara, 44124 Ferrara, ItalyNuclear Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, ItalyNuclear Medicine Unit, Onco-Hematology Department, University Hospital of Ferrara, 44124 Ferrara, ItalyDepartment of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, ItalyProstate cancer (PCa) is a high-prevalence disease usually characterized by metastatic spread to the pelvic lymph nodes and bones and the development of visceral metastases only in the late stages of disease. Positron Emission Tomography (PET) plays a key role in the detection of PCa metastases. Several PET radiotracers are used in PCa patients according to the stage and pathological features of the disease, in particular <sup>68</sup>Ga/<sup>18</sup>F-prostate-specific membrane antigen (PSMA) ligands. Moreover, 2-deoxy-2-[18F]fluoro-D-glucose <sup>18</sup>F-FDG PET usually shows metastases in the late stages of disease, when dedifferentiated neoplastic clones lose PSMA expression. In some cases, PCa patients may present atypical sites of metastases, with uncommon appearance at PET imaging with different radiotracers. We present the case of a patient with biochemical recurrence of PCa (ISUP Grade Group IV; PSA 4.7 ng/mL) showing atypical sites of metastases (the testis and multiple lung nodules) with absent PSMA expression and high [<sup>18</sup>F]FDG avidity. The patient showed diffuse positivity to alpha-methylacyl-coenzyme A racemase (AMACR). Moreover, a literature review was performed by collecting cases of PCa patients with atypical metastatic spread detected via PET imaging, with the aim of highlighting the relationship between atypical sites of metastases, imaging presentation, and pathology findings.https://www.mdpi.com/2218-273X/15/1/17prostate cancerPCaPSMAPSMA PETPET/CTPSMA negative PCa |
| spellingShingle | Ilham Badrane Angelo Castello Matteo Brunelli Corrado Cittanti Sara Adamantiadis Ilaria Bagni Noemi Mindicini Federica Lancia Massimo Castellani Licia Uccelli Mirco Bartolomei Luca Urso Atypical Metastases from Prostate Cancer: Alpha-Methylacyl-Coenzyme A Racemase (AMACR) as a Potential Molecular Target in Prostate-Specific Membrane Antigen-Negative Prostate Adenocarcinoma Biomolecules prostate cancer PCa PSMA PSMA PET PET/CT PSMA negative PCa |
| title | Atypical Metastases from Prostate Cancer: Alpha-Methylacyl-Coenzyme A Racemase (AMACR) as a Potential Molecular Target in Prostate-Specific Membrane Antigen-Negative Prostate Adenocarcinoma |
| title_full | Atypical Metastases from Prostate Cancer: Alpha-Methylacyl-Coenzyme A Racemase (AMACR) as a Potential Molecular Target in Prostate-Specific Membrane Antigen-Negative Prostate Adenocarcinoma |
| title_fullStr | Atypical Metastases from Prostate Cancer: Alpha-Methylacyl-Coenzyme A Racemase (AMACR) as a Potential Molecular Target in Prostate-Specific Membrane Antigen-Negative Prostate Adenocarcinoma |
| title_full_unstemmed | Atypical Metastases from Prostate Cancer: Alpha-Methylacyl-Coenzyme A Racemase (AMACR) as a Potential Molecular Target in Prostate-Specific Membrane Antigen-Negative Prostate Adenocarcinoma |
| title_short | Atypical Metastases from Prostate Cancer: Alpha-Methylacyl-Coenzyme A Racemase (AMACR) as a Potential Molecular Target in Prostate-Specific Membrane Antigen-Negative Prostate Adenocarcinoma |
| title_sort | atypical metastases from prostate cancer alpha methylacyl coenzyme a racemase amacr as a potential molecular target in prostate specific membrane antigen negative prostate adenocarcinoma |
| topic | prostate cancer PCa PSMA PSMA PET PET/CT PSMA negative PCa |
| url | https://www.mdpi.com/2218-273X/15/1/17 |
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