Prostate cancer - staging

Discussion:

This case shows an already histologically proven multifocal prostate cancer.

Histology of the systematic biopsy taken 4 months earlier showed intermediate and high-grade acinar adenocarcinoma (modified Gleason score 3+4=7a and 4+4=8)  of the left base and mid gland and low-grade acinar adenocarcinoma (modified Gleason score 3+3=6) within one core taken from the right lateral base.

MRI, which was done for radiation therapy planning and staging purposes, reflects the findings in the left lobe and also shows a possible small lesion of the right apical/midglandular posterolateral peripheral zone. The right lateral base appears normal on MRI, which could be due to either the low Gleason score or the positive biopsy sample being taken from a more apical location than labeled.

The lesion in the left posterolateral base of the prostate shows signs of extraprostatic extension (capsular contact and capsular breach).

The MRI also suggests an involvement of the left central zone with extension into the left ejaculatory duct and left seminal vesicle.

The patient received intensity-modulated radiotherapy.

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