57b - Answer: 66-year-old male presents with elevated PSA, negative biopsy
HISTORY:
This 66-year-old male presents with elevated PSA, negative biopsy.
PRIMARY FINDING:
PI-RADS 5.
FINDINGS:
Prostate measures 5cm in transverse dimension, 3.5cm in AP dimension and 3.5cm craniocaudal dimension with calculated bullet volume of 41mL.
A 2.6cm in maximum dimension hypointense mass at the left mid and apical peripheral zones with restricted diffusion and arterial enhancement. There is subtle nodularity along the capsule. Loss of fat plane to the neurovascular bundle. No hypointense mass in the transitional zones. Seminal vesicles unremarkable.
No lymphadenopathy in the visualized pelvis. No focal suspicious osseous lesions. Bilateral inguinal hernia with fat.
CONCLUSION:
A 2.6cm in maximum dimension hypointense mass at the left mid and apical peripheral zones with restricted diffusion, PI-RADS 5. Subtle irregularity of the capsule suspicious for transcapsular extension.
Case Challenge: Prostate MRI Cases
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Content reviewed: October 25, 2021