18F-Fluciclovine Uptake in an Incidentally Discovered Meningioma in a Patient With a History of Metastatic Prostate Cancer: A Case Report

Meningiomas are common, benign tumors found in the dural layers of the central nervous system (CNS) that are often found incidentally. (18)F-fluciclovine is an amino acid radiotracer that is used to monitor the recurrence of prostate cancer due to its high uptake in prostate cancer cells. This case report outlines a patient with a retinoblastoma tumor suppressor gene (RB1) mutation and prostate cancer metastasis to the bone incidentally noted to have an enhancing, extra-axial mass on a screening MRI. On prior scans, the mass displayed increased (18)F-fluciclovine uptake. Because prostate cancer can metastasize to the meninges, especially in older patients with advanced disease, consideration was given to the progression of his oncological disease. However, additional imaging validated the existence and size of the mass, making a meningioma the final diagnosis. Meningeal metastases can be virtually indistinguishable from other CNS tumors, including meningiomas appearing as single or multiple dural-based, enhancing masses, and without prior imaging, further investigation is warranted.