Atypical presentation of metastatic castrate resistant prostate cancer in a middle aged african male with good response to radioligand therapy.

Prostate cancer typically follows a characteristic pattern of metastatic spread to the pelvic lymph nodes and bone. Atypical pattern of metastasis is rare but has been documented. In African men, this disease tends to follow a more aggressive course, with the possibility of atypical site of metastatic spread. We present a case of a 58 year old African male, with metastatic castrate resistant prostate cancer, who presented with both typical and atypical pattern of metastatic disease detected by a fluorine 18 prostate specific membrane antigen (18F - PSMA) PET/CT scan. This patient also had good response to radioligand therapy.