Locally advanced metastatic prostate adenocarcinoma

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Poor urinary stream and markedly elevated PSA.

Patient Data

Age: 80 years
Gender: Male

A huge mass, 125 mm in the largest diameter, with heterogeneous enhancement and irregular borders, is noted in the anatomical location of the prostate gland that infiltrates the posterior wall of the urinary bladder, the anterior wall of the distal rectum, and the bilateral seminal vesicles.

A few enlarged lymph nodes are observed in the right parailiac regions.

In imaged portions of the lower thorax, a 38 mm well-defined subpleural mass is noted in the right lung base, inferring metastasis.

A few subcentimeter simple cortical cysts are seen in the kidneys.

Advanced degenerative changes, including osteophytosis, are seen in the lumbar spine. An osteoblastic lesion is noted in the right iliac bone, suggesting metastasis.

Bilateral inguinal hernia is present that contain bowel loops. There is also left-sided hydrocoele.

An inter-muscular lipoma is evident between the right gluteus minimus and medius muscles.

Case Discussion

Pathology-proven prostate adenocarcinoma with local invasion into the urinary bladder wall, rectal wall and seminal vesicles, right para-iliac lymphadenopathy, osseous and pulmonary metastasis.

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