18F-PSMA PET/CT is an emerging standard of care in staging prostate cancer, evaluating biochemical recurrence and response to therapy. Despite the nomenclature, PSMA expression is also documented at the tumor-associated neovasculature of other malignant solid tumors including renal cell carcinoma. We report a case of 44-year-old man known to have renal cell carcinoma who underwent 18F-PSMA and 18F-FDG PET/CT for restaging after radical nephrectomy. A well-defined solitary cerebellar lesion with marked PSMA expression and equivocal FDG uptake was noted. MRI brain confirmed a matching cerebellar metastatic lesion. 18F-PSMA expression in the metastatic RCC raises a prospective guide to futuristic theragnostic uses.

68Ga-PSMA is a promising tracer for both primary staging and detection of biochemical recurrence in prostate cancer. PSMA is also expressed in the neovascular endothelium of various solid malignancies possibly due to tumor-associated angiogenic factors and endothelial cell sprouting. We report a case of a 73-year-old man of prostate cancer with rising prostate-specific antigen levels. 68Ga-PSMA PET/CT was performed, which showed a focal lung lesion, with subsequent histological confirmation of adenocarcinoma of the lung. Incidental lung lesions on 68Ga-PSMA in prostate cancer patients should elicit a differential of primary lung malignancy, especially if clinical and morphological suspicion is high.

18 F-DOPA is a promising radiotracer used for both staging and restaging of primary brain tumors based on increased transport via the Ltype large neutral amino acid transport system in tumor cells. Adult medulloblastoma is extremely rare. We present a case of 25-year-old man with posterior fossa medulloblastoma treated with surgery followed by chemotherapy and radiotherapy 5 years back, which later developed metastasis to left cerebral lobe treated with gamma knife followed by surgical debulking. Recent 18 F-DOPA PET/CT demonstrates recurrence and disease progression on follow-up scan. 18 F-DOPA PET/CT is extremely useful for characterizing brain tumors, response assessment, and prognosis.

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