Metastatic involvement of the perirenal fascia has been reported in melanoma, urinary bladder, lung, and gastrointestinal neoplasms, while only Chandekar and colleagues [34] have reported a case from PCa detected with [68Ga]Ga-PSMA in a patient with a PSA of 226 ng/mL and ISUP Grade Group 3. This evidence concerns the gene KLK3 and posterior cortical atrophy.