Abdominal Splenosis Mimicking Peritoneal Metastasis in Prostate-Specific Membrane Antigen PET/CT, Confirmed With Selective Spleen SPECT/CT

Ga-prostate-specific membrane antigen (PSMA) PET/CT is a rapidly evolving diagnostic technique to image prostate cancer. In contrast to the name PSMA, various tissues show Ga-PSMA uptake in PET/CT imaging. We present a case of a 68-year-old man with prostate cancer who underwent Ga-PSMA PET/CT. Along with metastatic lymph nodes, multiple nodular lesions within the peritoneal spaces of all 4 quadrants of the abdomen showed high PSMA expression. Because of a history of splenic rupture, a Tc-labeled heat-denatured erythrocyte scintigraphy and SPECT were performed. Peritoneal lesions showed high uptake, confirming widespread peritoneal splenosis.