AUTHOR=Feng Yaqi , Zhao Wenjiang , Feng Yawen , Dai Wenli 

TITLE=A tumor-like renal arteriovenous malformation on 18F-PSMA-1007 PET/CT: a case report

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1420473

DOI=10.3389/fmed.2024.1420473

ISSN=2296-858X

ABSTRACT=Background: Renal arteriovenous malformations (rAVMs) are congenital abnormal pathways between renal arteries and veins that are rare in the general population. It is often misdiagnosed as malignant renal tumors with abundant blood supply, and the definitive diagnosis primarily relies on angiography. Multimodality imaging, including contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT plays an important role in the differential diagnosis of renal space-occupying lesions.Case presentation: A 56-year-old man presented with abdominal distension, loss of appetite, and back pain without obvious cause two years ago, without nausea vomiting, or frequent urination.Gastroscopy and colonoscopy showed multiple polyps in the duodenum and colon. Abdomen contrast-enhanced CT revealed a mass of 1.6×1.4cm in the left kidney, which was considered to be a malignant tumor. PET/CT was performed for further diagnosis; the 18 F-fluorodesoxyglucose ( 18 F-FDG) PET/CT scan showed mild uptake in the left renal mass, while no uptake of 18 F-prostatespecific membrane antigen (PSMA) was observed. Following a multidisciplinary discussion, the possibility of renal AVMs was considered and subsequently confirmed by renal angiography as the diagnosis. Then, selective segmental renal artery embolization was performed for treatment.Renal AVMs are extremely rare in clinical practice. Due to limited research on the application of 18 F-FDG and 18 F-PSMA PET/CT to renal AVMs, its role remains largely unexplored.With the increasing popularity of PET/CT imaging, comprehensive imaging of the disease has become indispensable. We report the first case of PSMA PET/CT imaging in renal AVMs, and when PSMA expression is absent in a renal mass, the possibility of renal AVMs should be considered.