A rare tumor, intestinal-type adenocarcinoma (ITAC), accounts for 8-25% of all sinonasal malignancies. The tumor’s histological resemblance to gastrointestinal tract adenocarcinoma is implied by its name. ITAC develops in the ethmoid sinus and upper nasal cavity. Herein, we present sinonasal ITAC with increased prostate-specific membrane antigen expression and fluorodeoxyglucose uptake.