In 04/2021, the patient presented with elevated PSA of 0.48 ng/mL and a [68Ga]Ga-PSMA-11 positron emission tomography/computed tomography (PET/CT) was conducted which revealed progression by showing a new rib and lymph node metastasis. The gene discussed is FOLH1; the disease is metastatic malignant neoplasm in the lymph nodes.