Male 46 years old with recently diagnosed high risk prostate cancer. Staging exam. PELVIS:PROSTATE:Prostate Size: 4.9 x 3.3 cmPeripheral Zone: There are multiple T2 hypointense lesions involving the peripheral zone. The dominant lesion is predominantly anterior from the mid gland to the apex with involvement of the central gland and anterior extracapsular extension (series 901, images 12 and 16). There are additional lesions in the right posterior apex involving the neurovascular bundle (series 901, image 11) and in the mid peripheral zone at the apex with extracapsular extension (series 901, image 12). The lesions are hyperintense on DWI, dark on ADC and demonstrate early contrast enhancement.Central Gland: The central gland is involved by the anterior peripheral zone lesion as described above.Seminal Vesicles: No evidence of disease extension into the seminal vesicles.Extracapsular Extension: There is extracapsular extension from the anterior lesion as well as from the lesion in the mid peripheral zone at the apex.BLADDER: No significant abnormality noted.LYMPH NODES: There is a 6 x 5 mm enhancing left pelvic node at the sacrosciatic notch (series 901, image 29)BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Multiple lesions consistent with prostate carcinoma. The dominant lesion is predominantly anterior, involved the central zone and has extracapsular extension. A second lesion in the mid posterior apex also demonstrates extracapsular extension.2.A lesion at the right post apex involved the neurovascular bundle.3.Left pelvic lymph node is suspicious for metastatic disease.Findings discussed by phone with Dr. Zagaja at 8:35 am on 11/22/2016