Presentation
Elevated PSA and hard prostate on rectal exam
Patient Data
A neoformative solid lesion in the peripheral zone of the prostate with irregular borders, low T1 and T2 signal and restricted diffusion. The posterior part of the lesion exhibits a large multilobulated, well-defined component with low T1 and high T2 signal without restricted diffusion, suggestive of mucinous degeneration.
The mass encompasses the seminal vesicles and extensively contacts the urinary bladder, mesorectal fascia, and both internal obturator muscles, causing rectal displacement and signs of mucin infiltration at the junction of the anterior rectal quadrants.
No lymph node enlargement.
Case Discussion
The patient had pathology-proven prostatic adenocarcinoma with mucinous features, Gleason 9 ISUP 5 in 95% of the gland, pT4pNX.
Mucinous adenocarcinomas of the prostate, also known as colloid adenocarcinomas, represent a subtype of acinar adenocarcinoma distinguished by the presence of mucinous characteristics. They typically appear hyperintense in T2 images and generally have outcomes that are comparable to or even more favorable than those of classic adenocarcinomas.
Case courtesy of Dr. Kai Vilanova.
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