Pancreatic Neuroendocrine Tumor incidentally found on 68Ga-PSMA PET/CT

Prostate-specific membrane antigen (PSMA) is highly expressed on prostate cancer (PCa) epithelial cells as well as the tumor neovascularity many other neoplasms. We present a case of a 67-year-old man with biochemically recurrent PCa who underwent 68Ga-PSMA-11 PET/CT, which demonstrated an intensely radiotracer-avid pancreatic neuroendocrine tumor. This case demonstrates the equivocal nature of pancreatic lesions, and reinforces the need for further work-up of unusual patterns of uptake, on PSMA-targeted PET/CT. The differential diagnosis of a radiotracer-avid pancreatic lesion should include primary malignancies, among them adenocarcinoma and neuroendocrine tumors.