Port-site metastasis is an extremely rare complication following minimally invasive oncologic surgery for prostate cancer. We present the case of a 74-year-old man who underwent robot-assisted laparoscopic radical prostatectomy followed by salvage radiotherapy. Despite treatment, he developed biochemical recurrence. However, there was no evidence of disease on CT and bone scan at a prostate-specific antigen of 4.6 ng/mL. Subsequently, 18F-DCFPyL PET/CT revealed a solitary focus of intense uptake in the right rectus abdominis muscle that was felt to represent a port-site metastasis. Histopathologic evaluation with immunostaining following ultrasound-guided needle biopsy confirmed the presence of metastatic adenocarcinoma of the prostate.

68Ga-DOTATATE PET/CT is indicated for selecting patients for peptide receptor radionuclide therapy (PRRT). Although highly sensitive, the detectability of smaller lesions, particularly in the liver, is lower. We present the case of a 58-year-old man with metastatic well-differentiated pancreatic neuroendocrine tumor whose MRI revealed progression of hepatic metastases. 68Ga-DOTATATE PET/CT performed to determine eligibility for PRRT did not demonstrate DOTATATE-avid disease within the liver. 18F-FDG PET/CT was also negative at the liver and the patient proceeded to 177Lu-DOTATATE PRRT, where multi–time point posttherapy planar imaging and SPECT/CT showed intense uptake in the known liver metastases.