We herein present a unique case of prostate cancer where <sup>68</sup> Ga-PSMA-11 positron emission tomography (PET)/computed tomography (CT) detected two unusual metastatic sites (testis and rectum) in a single patient at initial staging, resulting in an accurate determination of the extent of disease, more tailored multimodal treatment planning, and exploration of the theragnostic potential. This evidence concerns the gene FOLH1 and prostate carcinoma.