Interesting Images99mTc-HDP Bone Scintigraphy, SPECT/CT, and 18F-FDG PET/CT Diagnosis Imaging of Incidental Pleural Mesothelioma in a Patient With Biochemical Recurrences of Prostate Cancer Is it Really a Coincidence?Fernández-Rodríguez, Paula MD*; Martín-Marcuartu, Juan José MD*; Acevedo Báñez, Irene MD*; Masero Carretero, José Manuel MD†; Jiménez-Hoyuela García, José Manuel MD, PhD*Author Information From the Departments of *Nuclear Medicine †Pathology, Virgen del Rocío University Hospital, Seville, Spain. Received for publication June 25, 2019; revision accepted October 28, 2019. The work was performed in Virgen del Rocío University Hospital, and it has not been presented before. Conflicts of interest and sources of funding: none declared. Correspondence to: Paula Fernández-Rodríguez, MD, Nuclear Medicine Service, Virgen del Rocío University Hospital, Av Manuel Siurot, 41013 Seville, Spain. E-mail: email@example.com. Online date: January 30, 2019 Clinical Nuclear Medicine: March 2020 - Volume 45 - Issue 3 - p e148-e150 doi: 10.1097/RLU.0000000000002908 Buy Metrics Abstract We present the case of a 69-year-old man with history of prostate carcinoma treated with prostatectomy and subsequently with external beam radiotherapy and hormone therapy because of biochemical recurrences. More than 10 years after the diagnosis, follow-up 99mTc-HDP bone scans and SPECT/CT images demonstrated an incidental diagnosis of osteoblastic pleural plaques that quickly evolve to mesothelioma. PET/CT achieved the definitive diagnosis by guiding the biopsy to the highest and most accessible focus of glucidic hypermetabolism. Our case report raises the association between prostate cancer patients treated with external beam radiotherapy and the development of pleural mesothelioma despite having no history of exposure to asbestos. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.