Given the lower overall PSMA expression in immunohistochemistry, the only reasonable explanation for the contradictory PSMA and histological findings of our case seem to lie in the fact that high PSMA uptake on PET/CT does not necessarily indicate high PSMA expression in the tumour tissue, but it is rather influenced by other factors such as vascular density, blood flow, or nonspecific ligand binding. Here, FOLH1 is linked to neoplasm.