Presentation
High PSA 9.9. Firm left lobe on rectal examination. Father has prostate cancer.
Patient Data
Prostate volume 33mls. PSA density is 0.23ng/ml.
2.5 cm T2 signal lesion in the posterolateral aspect of the right peripheral zone at the level of the mid gland and base. Associated b1400 change and avid ADC restriction (PIRADS 5). Long segment of capsule abutment and minor irregularity.
Normal differential transitional zone.
Bilateral external iliac and pelvic side wall nodes measuring up to 7 mm. Morphologically these are not suspicious.
Normal seminal vesicles. No focal bone lesion
Case Discussion
Right-sided PIRADS 5.
Radiological stage early T3a,N0,Mx.
The early T3a status is from the long segment of capsular abutment.
TRUS biopsy: Prostatic adenocarcinoma
Gleason 9 (5+4) in the right lobe. Benign left lobe.