Introduction : Ga68-PSMA PET/CT has a crucial role in staging, evaluation of treatment, and diagnosis of local recurrence of prostate tumors and has recently been suggested by some guidelines as a staging method for intermediate and high-risk patients. This study aimed to evaluate the correlation between serum PSA levels and Gleason score of the prostate tumor, with the findings of Ga68-PSMA PET/CT scan in primary staging. Methods In the present cross-sectional study, all patients with prostate cancer who were referred to the nuclear medicine ward of Razavi Hospital, Mashhad, Iran, for Ga68-PSMA PET/CT whole body scan from 21 March 2021 until 21 March 2022 were enrolled. The results of each of the three stages of the scan (early, whole-body, and late) were recorded. The standardized uptake value of Ga68-PSMA in the primary tumor and its association with serum PSA, tumor Gleason score, and presence of tumor metastasis were evaluated and analyzed. In all statistical analyses, p < 0.05 was considered statistically significant. Findings : In total, 49 male patients with a median age of 65 years (Interquartile range: 59–69) were studied. 43.9% of the patients were in the high-risk group (Gleason score 9–10). The median serum PSA level was 17 ng/mL (Interquartile range: 8.02–42.10). PSA levels correlated with the SUVmax of the tumor in the whole-body stage of the scan (p < 0.05, r = + 0.392) but not early or late stages (p > 0.05). Gleason scores were positively correlated with tumor SUVmax in all three scan stages (p < 0.05). Conclusion Our results indicated that the Gleason score significantly correlated with the SUVmax of the prostate tumor in all three stages of the scan; however, serum PSA levels correlated with the tumor SUVmax in the whole-body stage of the scan but not in the early and late stages. In the whole-body stage, higher SUVmax was significantly associated with higher Gleason scores (9–10 vs. 7–8), bladder wall and seminal vesicle invasion, and lymph node metastasis (p < 0.05 in all cases), too.

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Supralevator fistula stays a challenge in general surgery. We present a case with supralevator anorectal fistula and subsequent retroperitoneal necrotizing fasciitis in which autologous platelet-rich plasma and platelet-rich fibrin glue were used for fistula closure. A 59-year-old man was admitted with pelvic pain and fever. Abdominopelvic sonography and CT scan reported a deep horseshoe-shaped anorectal abscess with extension to the pelvic floor, supralevator, psoas, retroperitoneal muscles, and kidneys. He was managed with antibiotics, abscess drainage, repeated radical surgical debridement, and necrosectomy. After 30 days, he was discharged, but he returned to the office with the complaint of purulent discharge from the hypogastric region and a diagnosis of fistula formation. Platelet-rich plasma was injected around the fistula into the tissue, and platelet-rich fibrin glue was introduced to the fistula tract. At the 11-month follow-up, the patient did not have voiding dysfunction, constipation, diarrhea, or fistula tract infection. Autologous platelet-rich plasma injection and platelet-rich fibrin glue insertion suggest a secure and effective approach for treating supralevator anorectal fistula.