A 69-year-old man presented with rising PSA (0.16ng/ml) following radical prostatectomy for Gleason score 7 prostate cancer 4 years prior. PSMA PET CT showed a solitary pelvic node with no prostate fossa recurrence. The patient underwent salvage radiotherapy including both fossa and pelvic node fields. PSA continued to rise, and repeat PSMA imaging showed new sites of PSMA-avid nodal disease in the common iliac region, directly above the radiotherapy field.
L Emmett et al., St Vincent's Hospitals, Sydney, Australia