73-year-old male patient with history of prostate cancer with possible future focal ablation.He underwent a prostate biopsy in September 2014 which was prompted by abnormal DRE (right sided nodule) and PSA of 4.0.Prostate biopsy (6 cores total) from 9/2014 revealed 1 core of Gleason 3+3 15% LB1 core Gleason 4+3, 90% RB1 core Gleason 3+4, 40% RM PELVIS:PROSTATE:Prostate Size: 5.3 x 3.2 x 3.8 cm (ML x AP x CC).Peripheral Zone: In the base and mid right peripheral zone there is a 2.0 x 11.1 cm (series 1004 image 284) focus of decreased T2 and ADC signal. Additionally, in the mid left peripheral zone there is a focus of decreased T2 and ADC signal that measures 0.6 x 0.5 cm (series 901 image 16).Central Gland: No suspicious lesions.Seminal Vesicles: The right sided lesion appears to abut the base of the right seminal vesicles.Extracapsular Extension: There right capsular border is indistinct (series 9 image 19) and there is invasion of the neurovascular bundle at this level. BLADDER: No significant abnormality noted.LYMPH NODES: There is a left external iliac lymph node that measures 1.2 x 0.8 cm (series 1301 image 32). There is a mildly enlarged right external iliac lymph node (series 1301 image 32). There is a small subcentimeter lymph node at the aortic bifurcation (series 2201 image 164).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is a cystic lesion at the left prostate base adjacent to the prostatic urethra that measures 1.2 x 1.0 x 1.1 cm.
1.Right base and mid peripheral zone cancer with extracapsular extension, invasion of the neurovascular bundle, and abutment of the right seminal vesicles.2.Small lesion in the mid peripheral zone compatible with additional focus of cancer.3.Mildly enlarged bilateral external iliac lymph nodes and subcentimeter node at the aortic bifurcation.4.Probable left apex prostatic retention cyst.