Solitary Penile Metastasis of Prostate Cancer on 18F-Fluciclovine PET/CT Imaging in a Patient With PSA of 1 ng/mL

An 85-year-old asymptomatic man with suspected biochemical recurrence of prostate cancer underwent an F-18-fluciclovine PET/CT scan, which revealed a solitary suspicious tracer uptake in the dorsal right corporal body of the proximal pendulous penis. The patient underwent ultrasound-guided fine-needle aspiration of the penile lesion, which revealed metastatic prostate cancer. The patient had definitive external beam radiation therapy 3 years before the examination. At the time of scan, the prostatic-specific antigen (PSA) was only 1.0 ng/mL, although the PSA doubling time was 2.6 months. It is unusual to detect a solitary penile metastasis in a patient with a low level of PSA.