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Prostate-Specific Membrane Antigen Accumulation in Lower Extremity Lymphedema

Zhang, Jingjing, MD, PhD; Kulkarni, Harshad R., MD; Singh, Aviral, MD, MSc; Baum, Richard P., MD, PhD

doi: 10.1097/RLU.0000000000002552
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Prostate-specific membrane antigen (PSMA) is overexpressed in a majority of prostate cancer cells, which has led to the development of radiolabeled small-molecule inhibitors of PSMA for molecular imaging and targeted radioligand therapy. 177Lu-labeled PSMA, with therapeutic β-emission and concomitant γ radiation, permits posttherapy imaging for the assessment of biodistribution and uptake in tumors and normal organs, as well as dosimetry. We report a patient with prostate cancer and metastatic lymph nodes–related lower extremity lymphedema, who presented with dermal backflow and soft-tissue uptake in the lower extremity on posttherapeutic whole body scan after intravenous 177Lu-PSMA treatment.

From the THERANOSTICS Center for Molecular Radiotherapy and Precision Oncology, Bad Berka, Germany.

Received for publication January 31, 2019; revision accepted February 6, 2019.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Richard P. Baum MD, PhD, THERANOSTICS Center for Molecular Radiotherapy and Precision Oncology, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437 Bad Berka, Germany. E-mail:

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