52b - Answer: 64-year-old male presents with adrenal carcinoma neoplasm
HISTORY:
This 64-year-old male presents with adrenal carcinoma neoplasm of prostate diagnosis. Prostate biopsy left lateral apex Gleason 7 (3+ 4). Left medial apex microscopic focus of atypical glands. PSA 5.5. No surgery.
PRIMARY FINDING:
PI-RADS 4.
FINDINGS:
The prostate measures 4 cm craniocaudal, 3.2 cm transverse and 2.6 cm AP. The prolate ellipsoid volume is 17.3 mL. The PSA density is 0.31 ng/mL per cc.
Peripheral zone:
Rounded 9 mm left apical peripheral zone posterolaterally (PZpl) marked restricted diffusion consistent with a PI-RADS 4 lesion. Early enhancement.
No other areas of restricted diffusion in the peripheral zone. Benign 6 x 10 mm nonenhancing cyst of the posterior midline of the peripheral zone.
Transition zone:
Mild benign prostatic hyperplasia. No suspicious lesions.
Other:
Normal seminal vesicles and neurovascular bundles.
No suspicious soft tissue or bony lesion. No lymphadenopathy.
CONCLUSION:
9 mm PI-RADS 4 lesion in the left peripheral zone posterolaterally at the apex. (Likert grade 5 out of 5 based on imaging characteristics.) No other significant lesions.
Case Challenge: Prostate MRI Cases
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Content reviewed: October 25, 2021