History of prostate cancer. Pathology dated 1/13/2016 showed 3+4 in right base lateral 1 mm 5%, right base lateral 2.5 mm 15%, right mid lateral 7 mm 50%, right Apex lateral 5 mm 30%. PELVIS:PROSTATE:Prostate Size: 2.9 x 5.3 x 6.0 cmPeripheral Zone: Dominant lesion in the medial aspect of the mid gland extending to the apex measuring up to 1.1 x 0.8 cm in maximal cross section demonstrating T2 weighted hypointensity (series 401 image 11 through 13) and restricted diffusion (series 603 image 244 through 164)Central Gland: Mild changes of benign prostatic hyperplasia.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: The right mid gland to apex lesion has a broad base of abutment with the prostate margin with suspected focal extension posteromedially (series 401/11).BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: Along the course of the right obturator nerve between the pectineus muscle and adductor brevis muscle there is a well-defined oval mass measuring up to 2.9 x 1.8 x 4.5 cm. The lesion is isointense to the musculature on T1-weighted imaging and heterogeneously hyperintense on T2-weighted imaging, demonstrating heterogeneous postcontrast enhancement. Punctate focus of T1-hyperintensity and low signal intensity suggests blood product and/or calcifications.OTHER: No significant abnormality noted.
1.1.1 cm right peripheral zone mid gland to apex lesion with broad-based abutment of the prostate margin with suspected extraprostatic extension posteromedially. No enlarged pelvic lymphadenopathy.2.Incidental 2.9 cm oval enhancing well-defined mass along the course of the right obturator nerve extending into the medial thigh. Differential considerations include a peripheral nerve sheath tumor or hemangioma, amongst others. Referral to orthopedic oncology is recommended for further evaluation, including dedicated imaging, including radiographs to evaluate for calcifications. (Discussed with urology service Dr. Eggener/Karens (sp?) at 1539 on 03/09/2016.)