Brown Tumour Mimicking Skeletal Metastasis in ⁶⁸ Ga-PSMA PET/CT

We report a case of a patient with chronic kidney disease who underwent 68 Ga-PSMA (prostate-specific membrane antigen) positron emission tomography/computed tomography (PET/CT) for suspected prostate carcinoma in the setting of equivocal multiparametric magnetic resonance imaging (MRI) findings, a suspicious bone lesion, and a negative prostate biopsy. Imaging demonstrated diffuse PSMA uptake in the prostate and PSMA-avid lytic lesion of the iliac bone, which was subsequently confirmed to represent a brown tumour secondary to renal osteodystrophy. This report highlights a previously unreported benign skeletal condition demonstrating PSMA uptake and mimicking metastatic disease.