A Rare Case of Appendiceal Metastasis From Prostate Adenocarcinoma in an Asymptomatic Patient With Biochemical Recurrence

ABSTRACT

We report a rare case of appendiceal metastasis from prostate adenocarcinoma in a 73‐year‐old male with a prior Gleason score 7 prostate cancer, initially treated with radical prostatectomy and adjuvant radiation in 2014. The patient presented in 2025 with a rising prostate‐specific antigen (PSA) and modest prostate‐specific membrane antigen (PSMA) uptake on positron emission tomography/computed tomography (PET/CT) at the tip of the appendix. Magnetic resonance imaging (MRI) demonstrated a corresponding appendiceal lesion with restricted diffusion and enhancement. Pathology following laparoscopic appendectomy confirmed metastatic prostate adenocarcinoma involving the appendix and periappendiceal lymph nodes. This case highlights the importance of correlating atypical PSMA PET/CT findings with anatomic imaging and, when needed, histologic confirmation in patients with biochemical recurrence of prostate cancer.