59-year-old male with prostate cancer and cystic mass. PSA 1.95 in May 2013, 4.730 in Feb 2014, 7.330 in March 2015. TRUS-guided saturation biopsy on 5/12/15 demonstrated 2 cores of Gleason 3+3=6 prostate adenocarcinoma (<5% of tissue) at the right anterior apex, 2 cores of Gleason 3+3=6 (30%) at the left anterior base, and three cores of Gleason 3+3=6 (15%) at the left posterior base. PELVIS:PROSTATE:Prostate Size: 6.1 cm TV x 4.7 cm AP x 7.0 cm CC.Peripheral Zone: There two 7 mm foci of T2 hypointensity with diffusion restriction, one in the right paramedian apex and one in the right base suspicious for carcinoma. Central Gland: Heterogeneous with small nodules.There is a 6.3 x 4.9 x 6.3 cm multilocular cystic nodule with enhancing septations and internal hemorrhage that is associated with the left aspect of the prostate gland and displacing the prostate rightward. Seminal Vesicles: No evidence of seminal vesicle invasion by the aforementioned subcentimeter foci in the right peripheral zone. Extracapsular Extension: No evidence of extracapsular extension.BLADDER: The bladder is displaced slightly rightward due the aforementioned cystic mass.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1.Two subcentimeter foci in the right prostatic peripheral zone at the apex and base suspicious for carcinoma. 2.6.3 cm multilocular cystic nodule with enhancing septations and internal hemorrhage at the left aspect of the prostate gland. The differential for this includes a giant multilocular prostate cystadenoma, a cystic carcinoma.