Reason: History of prostate cancer, scheduled for a RALP, evaluate for disease and for nerve sparing purposes.Additional history per electronic medical record:Pt noted to have a rise in his PSA to 5.2 ng/mL in May 2016 during routine screening. This prompted a transrectal ultrasound and prostate biopsy which revealed a Gleason 3+3 =6 in 7 of 12 cores. The positive findings were in L apex/mid/lat apex, R mid/apex/lat mid/lat apex. Maximum involvement was 30% in R lateral apex. PELVIS:PROSTATE:Prostate Size: 5.1 x 3.8 x 4.6 cm.Peripheral Zone: There is decreased T2 and ADC signal throughout much of the bilateral apices, mid glands, and bases with associated increased enhancement which is suspicious for neoplasm. There is a cystic area of nonenhancement within the left lateral base.Central Gland: The margin of the central gland and peripheral zone is indistinct with associated decreased T2 and ADC signal suggestive of tumor infiltration of the peripheral aspect of the central gland.Seminal Vesicles: There is abnormal signal and increased early enhancement within the left greater than right inferior aspects of the seminal vesicles suggestive of tumor infiltration.Extracapsular Extension: There is indistinctness of the right greater than left capsule suggestive of extraprostatic extension. There is also abnormal signal surrounding the right neurovascular bundle.BLADDER: No significant abnormality noted.LYMPH NODES: Nonspecific subcentimeter right external iliac lymph node.BONES, SOFT TISSUES: The bone marrow is mildly heterogeneous, but no discrete focal lesions are identified.OTHER: No significant abnormality noted.
Extensive tumor involvement throughout the prostate with extracapsular extension and involvement of the seminal vesicles.