60b - Answer: 58-year-old male presents with malignant neoplasm after biopsy
HISTORY:
This 58-year-old male presents with malignant neoplasm after biopsy one year prior. PSA 7.88.
PRIMARY FINDING:
PI-RADS 3.
FINDINGS:
Morphology: The prostate measures 4.8cm transverse, 5cm craniocaudal and 4cm AP. The prolate ellipsoid volume is 50cc.
Central zone hypertrophy with symmetrical anterior / posterior lobe enlargement. Resultant effaced peripheral zones.
Peripheral Zone: No restricted diffusion. No circumscribed hypointense T2 lesion. No enhancing lesions.
Transitional Zone: Multiple benign prostatic hyperplasia nodules. 19 x 10mm lenticular homogeneous moderately heterogeneous lesion in the base of the prostate involving the TZa and anterior fibromuscular stroma. No restricted diffusion or enhancement. No extracapsular extension.
Other: Normal seminal vesicles. Normal neurovascular bundles. No suspicious soft tissue or bony lesion. No pelvic lymphadenopathy.
CONCLUSION:
1. PI-RADS 3 lesion left transitional zone anteriorly (TZa) and anterior fibromuscular stroma (AS) at the base of the prostate. (Known Ca therefore equivalent of breast BIRADS 6 / PIRADS 6)
2. Normal peripheral zone.
Case Challenge: Prostate MRI Cases
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Content reviewed: October 25, 2021