Discordant Molecular Imaging Findings with 2-[¹⁸F]FDG and [⁶⁸Ga]Ga-PSMA PET/CT in a Patient with Both Bladder and Prostate Cancer

The prevalence of double primary prostate and bladder cancer is not uncommon. Though both share a common pathway of malignant transformation, they bear to differ in the case of 2-[F-18]FDG PET/CT and [Ga-68]Ga-PSMA uptake. We present a case of double primary cancer involving the bladder and prostate, where the prostatic primary showed intense [Ga-68]Ga-PSMA uptake with non-avid skeletal and pulmonary metastases, which showed intense 2-[F-18]FDG uptake, thus showing discordance due to different clonal origins.