Abstract
The inguinal lymph nodes are an unusual site of metastases for prostate adenocarcinoma. We present a case in which a 61-year-old man with biochemically recurrent prostate cancer underwent a 11C-acetate Positron Emission Tomography (PET)/ Computed Tomography Attenuation Correction (CTAC) scan which demonstrated multiple foci of increased activity in the left inguinal, left iliac chain, and right inguinal regions. The CTAC scan also showed anterior wall thickening of the rectum. The imaging findings were suggestive of metastatic involvement of the rectum below the dentate line with subsequent spread to the inguinal lymph nodes.