Presentation
Work up for gross hematuria and poor urinary stream.
Patient Data
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The prostate gland is markedly enlarged and infiltrates the base of the urinary bladder and both UVJs, causing bilateral hydroureteronephrosis, left more than right. The fat plane between the prostatic mass and the adjacent rectum seems to be preserved.
Several enlarged lymph nodes with short axis diameter (SAD) <20 mm at bilateral para-iliac regions. Additionally, several enlarged lymph nodes with a maximum SAD of 13 mm are seen at the para-aortic regions.
The gallbladder contains several stones <12 mm in diameter.
A small volume of pleural effusion on the right side in the imaged portion of the lower thorax.
Grade I spondylolisthesis of the L4 on L5 is evident.
Case Discussion
Pathology proven prostate adenocarcinoma with local invasion, para-iliac, and para-aortic lymphadenopathy.