Paget Disease: A Potential Pitfall in PSMA PET for Prostate Cancer.

We present a case of an 81-year-old man with multifocal Paget disease found on bone scan that was performed for incidentally diagnosed prostate cancer. The subsequent Ga-PSMA (HBED-CC) PET scan also displayed increased uptake in the same distribution. Multiple known tumors display increased Ga-PSMA uptake due to neovasculature. We postulate that increased Ga-PSMA uptake within the pagetoid bone relates to neovascularity known to occur in Paget disease. Such pagetic uptake could result in false-positive studies for bone metastases, particularly in the setting of less typical Paget disease.