A 76-year-old man with prostate cancer pT2c N0 M0 R1 GS9 (4+5) operated 2009 and radiated postoperatively underwent restaging by Ga-PSMA-PET in January 2017 because of PSA rise at 0.44 ng/ml under medication with GnRH analogues. An intense focal uptake of the diffusely enlarged left adrenal gland was observed as the only pathological finding. Further evaluation by MRI imaging revealed a plump left adrenal gland with a relatively enlarged diameter of 2 cm and excluded tumor and nodular hyperplasia as well. Without any change of the therapeutic regime the patient presented in July 2017 with a PSA level of 0.05 ng/ml and no sign of cancer progress.