In addition to the known metastatic osseous disease such as in the L2 vertebral body (SUVmax 10.1), 18F-DCFPyL PET/CT (Figure 1) revealed new PSMA-avid mediastinal (SUVmax 6.3) and left supraclavicular (SUVmax 4.0) adenopathy suspected to represent prostate cancer metastases. Here, FOLH1 is linked to Familial prostate cancer.