A 72-year-old man, who is known with a case of metastatic carcinoma of the breast, was referred for 18F-PMSA 1007 PET/CT with clinical suspicion of synchronous prostate cancer. 18F-PSMA 1007 PET/CT scan detected no abnormal tracer concentrating lesion in the prostate gland; however, abnormal tracer concentration was noted in soft tissue lesions in left breast, metastatic lymph nodes, and skeletal lesions. Compared with 18F-FDG PET/CT, more bone lesions were detected on 18F-PSMA 1007 imaging. The findings of our case open the possibility of imaging metastatic breast cancer with 18F-PSMA 1007 in men.

18 F-PSMA is a promising tracer for both staging and detection of biochemical recurrence in prostate cancer. PSMA is also expressed in the benign pathological conditions. We report a case of 81-year-old man with a known case of prostate cancer who underwent 18 F-PSMA for restaging. 18 F-PSMA PET/CT shows intense tracer uptake in the frontal bone appearing like an "Iron Man" sign. Corresponding noncontrast CT images, pagetoid changes with thickened cortex, mixed lytic/sclerotic mottled pattern. It is important to recognize 18 F-PSMA expression in the benign nonprostatic pathologies to avoid false interpretation.