Prostate cancer.PSA 6 months ago: 7 ng/mL.PSA May 20, 2015: 14.5 ng/mL.Prostate biopsy June 5, 2015, Gleason 8 prostate cancer and left mid, right mid, and right lateral apex. Greatest volume in right mid gland. Gleason 7 cancer at left apex, right lateral base, right base, right lateral mid gland. PELVIS:PROSTATE:Prostate Size: 5.0 x 3.2 cm.Peripheral Zone: There are several suspicious lesions in the peripheral zone demonstrating hypointense ADC and T2 signal abnormality. The largest, dominant lesion is located in the right mid gland extending to the apex, series 701, image 18. This demonstrates pathologic enhancement and suggestion of washout. The adjacent capsule is indistinct, suggesting extracapsular extension. Additional suspicious lesion in the left base is seen on series 701, image 21. There is bulbous appearance of the left mid gland as well, without definite T2 or ADC signal abnormality; this lesion is indeterminate.Central Gland: Nodular central gland. No nodules demonstrate suspicious signal characteristics.Seminal Vesicles: No evidence of seminal vesicle involvement.Extracapsular Extension: Extracapsular extension from the dominant right mid gland lesion is suspected, as above.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Lesions in the peripheral gland suspicious for known prostate adenocarcinoma. Dominant lesion in the right mid gland with appearance suspicious for associated extracapsular extension.