Male 60 years old with prostate cancer undergoing active surveillance. Staging exam. PELVIS:PROSTATE:Prostate Size: 5.3 x 4.2 cmPeripheral Zone: Several foci of low T2 signal intensity in the peripheral zone of the prostate gland are compatible with the known history of prostate cancer. The index lesion located anteriorly and there is evidence of extracapsular extension anteriorly, particularly on the left. The index lesion measures 3.4 x 1.5 cm (series 801, image 20), increased in size since 2011. An anterior apical focus has also increased in size now measuring 1.5 x 0.8 cm (series 801, image 12) and is invading the urethra. Additional small lesions have also increased in size.Central Gland: Large anterior transitional zone cancer with extracapsular extension.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: Anterior extracapsular extension.BLADDER: No significant abnormality noted.LYMPH NODES: Multiple small bilateral iliac and obturator nodes are unchanged and non-specific. Given the location they are not particularly suspicious for metastasis. The reference node in the left iliac chain measures 1.8 x 0.7 cm (series 1601, image 108), previously 1.8 x 0.6 cm.BONES, SOFT TISSUES: Bone marrow signal intensity is within normal limits.OTHER: No significant abnormality noted.
1.The index large anterior transitional zone cancer with extracapsular extension has increased in size. 2.A smaller lesion in the anterior apex invades the urethra. 3.Other small bilateral peripheral zone foci are also suspicious for prostate cancer and have also increased in size. 