Abstract We report the case of an 88-year-old man recently diagnosed with prostate cancer. The patient underwent a 68 Ga–prostate-specific membrane antigen–11 PET/CT for staging assessment. This examination revealed intense and expected uptake in the primary prostate cancer, widespread metastatic involvement including typical adenopathy and bone metastasis, and a less common pulmonary lymphangitic carcinomatosis. Most notably, we discovered a rare intrapericardial metastasis, which is an atypical site for metastasis in general and particularly for prostate adenocarcinoma.