Prostate cancer, status post docetaxel. Right perianal/gluteal numbness. Obstructive uropathy. PELVIS:PROSTATE/SEMINAL VESICLES: Interval decrease in size of the prostate and reference measurement right pelvic soft tissue nodule. There is soft tissue enhancement of the prostate.BLADDER: No significant abnormality noted.LYMPH NODES: Reference measurement left external iliac lymph node and adjacent thickening of the right internal obturator muscle have decreased in the interval. The right internal obturator muscle measures 1.3 cm in thickness compared to 2.5 cm on the 2/2/2016 CT exam, and contrast enhancement is suggestive of metastatic disease.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Persistent cortical thickening and trabecular expansion of the right hemipelvis with scattered areas of T2 hyperintensity and contrast enhancement suggesting a mixed appearance of Paget's disease and metastatic lesions. Additional metastatic foci are suspected in the sacrum and left posterior ilium.OTHER: No significant abnormality noted.INDEX LESION MEASUREMENTS (Current exam date/time: 7/12/2016 11:30:00)LEFT PELVIC LYMPH NODE: 0.7 x 0.4 cm (Image 85, Series 9); 0.4 x 0.4 cm on prior (6/29/2016) (Image 131, Series 201).RIGHT PELVIC SOFT TISSUE MASS: 1.8 x 2.0 cm (Image 67, Series 9); 2.8 x 2.6 cm on prior (6/29/2016) (Image 139, Series 201).
1.Interval decrease in size of the prostate, right pelvic soft tissue nodule, and right internal obturator muscle thickness. Contrast enhancement of the right internal obturator muscle suggests metastatic disease.2.MRI features suggesting a mixed appearance of Paget's disease and metastatic lesions within the right hemipelvis. Additional foci of osseous metastasis are suspected in the sacrum and left posterior ilium.