History of prostate cancer. EPIC Note: He has had 3 total biopsies for elevated PSA (3/2014, 1/2013, 10/2010) all of which were negative. Pt's last DRE was 4/2015 and states he has never had an abnl DRE. He is here today for a PSA that continues to rise in light of negative bx for MRI prior to URONAV bx this PM. PSA trend: 10/2011 - 3.07 2/2014 - 6.27 3/2015 8.49 5/2015 9.95 PELVIS:PROSTATE:Prostate Size: 2.9 x 4.6 x 5.3 cm.Peripheral Zone: Within the far right anterior peripheral zone and the transition zone at the mid gland there is an approximately 1.8 x 1.0 cm (series 1101/20) poorly marginated T2 weighted hypointense lesion with restricted diffusion with arterial enhancement and washout, there is extension to the level of the fibromuscular stroma.Central Gland: Benign prostatic hyperplasia. Median lobe hypertrophy.Seminal Vesicles: No evidence of seminal vesicle invasion.Extracapsular Extension: The lesion bulges the anterior margin of the prostate.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.8 cm lesion within the far right anterior peripheral zone and the transition zone at the mid gland extending to the level of the anterior fibromuscular stroma suspicious for prostatic carcinoma. This is amenable to MRI/ultrasound fusion biopsy. The lesion bulges the anterior margin of the prostate raising the possibility of extracapsular extension.