18F PSMA Uptake in a Hypogastric Desmoid Tumor

A 68-year-old man with a history of 2 primary tumors (prostate adenocarcinoma and colon adenocarcinoma) underwent 18 F-DCFPyL PET/CT for biochemical recurrence after prostate cancer treatment. A hypogastric nodular lesion with avid PSMA uptake was observed, interpreted as a possible implant. Surgical excision revealed a benign spindle cell proliferation compatible with a desmoid tumor (fibromatosis). This case highlights the potential pitfall of desmoid tumors mimicking malignancy on 18 F-DCFPyL PET/CT, emphasizing the importance of awareness and correlation with clinical and histopathologic findings.