Urethral Diverticulum Mimicking Metastatic Prostate Cancer on 68Ga-PSMA-11 PET/CT

Urethral diverticulum rarely occurs in a man. A 57-year-old man who underwent radical prostatectomy for prostate adenocarcinoma 9 years ago was referred for 68 Ga-PSMA-11 PET/CT scan for restating due to elevated serum total prostate-specific antigen level. 68 Ga-PSMA-11 PET/CT showed multiple PSMA-avid bone metastases and a focal intense activity in the anterior penis. The PSMA-avid penil lesion corresponded to a urethral diverticulum, which was initially detected on pelvic MRI 8 years ago. This case indicates that the urethral diverticulum should be included in the differential diagnosis of PSMA-avid penile lesions.