Splenunculus masquerading as PSMA-positive lymph node metastasis in a patient with PSA relapse after radical prostatectomy.

A 45-year old patient presented with prostate-specific antigen relapse after radical prostatectomy. Diagnostic workup revealed a (68)Ga-labeled prostate-specific membrane antigen-targeted ligand tracer uptaking nodule that was initially interpreted as lymph node metastasis but eventually identified as a splenunculus by scintigraphy with (99m)Tc pertechnetate-labelled heat-altered erythrocytes.

Awareness of this constellation may spare unnecessary diagnostic procedures and inappropriate treatment.

Urology. 2016 Apr 25 [Epub ahead of print]

Michael Froehner, Klaus Zöphel, Tobias Hölscher, Michael Laniado, Manfred P Wirth

Departments of Urology, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany. Departments of Nuclear Medicine, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany., Departments of Radiation Oncology und Oncoray, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany., Departments of Radiologic Diagnostics, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany., Departments of Urology, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany.