Unusual Case of Missed Penile Metastases on ⁶⁸Ga-PSMA PET/CT

A 75-year-old man with a history of previously treated localized prostate cancer and prostate-specific antigen of 4.86 ng/mL was referred for a Ga-68-prostate-specific membrane antigen PET/CT. PET imaging was reported to be negative. After subsequent review and re-read of the scan, prostate-specific membrane antigen imaging revealed uptake along the penile shaft (SUVmax of 14.7). MRI was compatible with tumor. Penile metastases from prostate cancer, although uncommon, do occur and readers are encouraged to distinguish penile metastatic uptake from residual urine in the urethra.