17b - Answer: 61-year-old male presents with elevated PSA level
HISTORY:
This 61-year-old male presents with elevated PSA level measuring 10.99ng/mL. Patient was diagnosed with prostate cancer previously.
PRIMARY FINDING:
PI-RADS V.
FINDINGS:
The prostate gland measures 3.3cm in CC, 4.7cm in RL and 3cm in AP dimensions. Calculated prostate volume is 30cc, and PSA density is 0.387. Ill-defined T2 hypointense region involving anterior transitional zone of the mid and apical segments with moderate to severe diffusion restriction (PI-RADS 5/5). Additional T2 hypointense lesion measuring 1.7cm in longitudinal axis is seen in the left mid and apical segment peripheral zone with moderate diffusion restriction (PI-RADS 3/5). The described lesions demonstrate abutment of the anatomical prostate capsule without evidence of extracapsular extension. Bilateral neurovascular bundles and seminal vesicles are preserved. Rectoprostatic angles are clear.
Urinary bladder is partially full and unremarkable.
No lymphadenopathy identified in the pelvis or inguinal regions. No free or loculated fluid collections.
Vasculature is patent.
No abnormal osseous enhancement. Visualized musculoskeletal structures are grossly normal.
Bilateral small fat-containing inguinal hernias are noted.
CONCLUSION:
1. PI-RADS 5/5, dominant lesions are at the transitional zone of bilateral mid and apical segments and left mid and apical segment peripheral zone.
2. No focal metastatic process.
Case Challenge: Prostate MRI Cases
Case Challenge
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Content reviewed: October 25, 2021