60-year-old man with history of Gleason 7 prostate adenocarcinoma in the right lateral apex. PELVIS:PROSTATE:Prostate Size: 57 x 33 mmPeripheral Zone: In the left prostatic apex (401/53, 503/184) there is a poorly defined 6 x 5 mm area of mild T2 hypointensity and ADC signal abnormality. Otherwise, the peripheral zone appears relatively normal.Central Gland: Within the right mid prostate gland anterior transitional zone (503/224, 401/59) there is ADC abnormality and markedly decreased T2 signal measuring 30 x 23 mm which crosses the midline.Seminal Vesicles: The seminal vesicles appear unremarkable.Extracapsular Extension: There are small areas of abnormal signal which may represent extraprostatic extension of tumor from the right anterior transitional zone (503/244).BLADDER: No significant abnormality noted.LYMPH NODES: No significant lymphadenopathy noted.BONES, SOFT TISSUES: In the proximal right femur (2001/13), right juxta-articular ilium (2001/114), and right iliac wing (2001/156), there are areas of abnormal enhancement and marrow signal.Bilateral inguinal hernias noted.OTHER: No significant abnormality noted.
1.Large area of abnormality in the right mid anterior transitional zone highly suspicious for neoplasm, possibly with a focus of extraprostatic extension.2.Questionable area of signal abnormality in the left apex, indeterminate for tumor. 3.Proximal right femur and right ilium lesions highly suspicious for metastases. The right femur lesion should be evaluated urgently for risk of pathologic fracture. Consider radiographs or bone scan. Findings discussed with Dr. Labbate by phone at 5:19 p.m. on 10/14/2016.4.No lymphadenopathy noted.