73Yrs gentleman on active surveillance for prostate cancer. He underwent TRUS guided prostate biopsy in 4/2014 for a PSA of 4.8 ng/ml which showed Gleason 6 in 2 cores - right lateral mid and lateral apex (maximal length of 3 mm). His PSA gradually increased- 5.6 in 5/2015, 5.8 in 12/15 and 6.9 in 8/16. He did not undergo a second biopsy. PELVIS:PROSTATE:Prostate Size: 5.1 x 5.2 x 5.0 cm.Peripheral Zone: There is an area of decreased T2 and ADC signal within the right lateral midgland and apex measuring 10 x 12 mm with suspected extracapsular extension. There are additional scattered small foci of decreased T2 and ADC signal within the left peripheral zone.Central Gland: No significant abnormality identified.Seminal Vesicles: No significant abnormality identified.Extracapsular Extension: See above.BLADDER: No significant abnormality noted.LYMPH NODES: No abnormally enlarged lymph nodes are identified within the pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: A penile prosthesis is noted.
Dominant lesion within the right lateral midgland/apex suspicious for neoplasm with suspected extraprostatic extension. Additional possible smaller lesions within the left peripheral zone.