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Conventionally, multiparametric magnetic resonance imaging (mpMRI) incorporating T2-weighted, diffusion-weighted, and dynamic contrast-enhanced sequences is considered the standard for detection and staging of clinically important prostate cancer (PCa).[1] The 68gallium (68Ga)-labeled positron emission tomography (PET) tracer targeting prostate-specific membrane antigen (PSMA), 68Ga-PSMA PET, is a promising tool for detection, localization, and staging carcinoma prostate.[2] Here, we present a case of PCa, showing incongruence between 68Ga-PSMA PET and the corresponding mpMRI findings. Moreover, the final histopathology revealed a surprise, which exemplifies the complementary nature of combining 68Ga-PSMA PET and mpMRI in the diagnosis and staging of carcinoma prostate.

35 yr old steroid dependent lady with Pulmonary TB underwent debridement of epidural abscess & posterior stabilization for paraparesis. With histopathology and cultures showing Aspergillus fumigatus, voricanozole was started. By the fourth week, she developed persistent fever, and altered mental status. Brain MRI and CSF study including multiplex PCR evaluation confirmed cerebral aspergillosis. Voricanozole was changed to intravenous lipid complex Amphotericin B to achieve sustained clinical and radiological response after six months of therapy.