# Concomitant Bilateral Inferior Gluteal Lymph Node Involvement in Metastatic Prostate Adenocarcinoma Detected on 68 Gallium-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography

## TL;DR

A rare case of prostate cancer spreading to both inferior gluteal lymph nodes was detected using a specialized imaging technique.

## Contribution

Reports a unique case of metastatic prostate cancer involving bilateral inferior gluteal lymph nodes.

## Key findings

- Prostate cancer metastasized to bilateral inferior gluteal lymph nodes in a 42-year-old male.
- These nodes are typically outside the radiation field and not accessible via standard surgery.
- This case highlights potential implications for treatment planning and patient prognosis.

## Abstract

An unusual and unique case of prostate adenocarcinoma with involvement of bilateral inferior gluteal lymph nodes is reported. The patient was a 42-year-old male, with conventional prostatic adenocarcinoma (Gleason score: 5 + 4 = 9), who, during disease progression with rising serum prostate specific antigen levels following medical androgen deprivation therapy, demonstrated new prostate-specific membrane antigen expressing metastatic intermuscular deposits in the bilateral gluteal region, subsequently proven to be bilateral inferior gluteal nodal metastasis. A therapeutic implication to this may be that these nodes usually fall beyond the range covered by the therapeutic radiation field coverage where external radiotherapy is the advocated modality of choice and are not easily reachable through standard surgical procedures. As a result, they could have an impact on the way patients are clinically treated and on their prognosis.