Abstract
Transformed small cell carcinoma of prostate represents a distinct tumor biology from the adenocarcinoma counterpart and penile metastasis from prostate cancer is a rare entity. Unique features of this transformation include unresponsiveness to hormonal therapy and presence of visceral metastases, which can demonstrate hypermetabolism on 18F-FDG PET/CT. The importance of dual tracer PET/CT using 68Ga-PSMA and 18F-FDG is illustrated in metastatic prostatic adenocarcinoma (Gleason’s score 4+3=7) with previous history of bilateral orchidectomy, chemotherapy and radiotherapy, who presented with abdominal pain and backache, dysuria and increasing serum PSA. The value of sequential dual tracer PET/CT to assess disease status, theranostics and monitoring response to multimodality therapies is illustrated.