Prostate cancer - T4 rectal invasion

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Back pain, weight loss, urinary retention. Metastases on MRI spine. Prostate primary?

Patient Data

Age: 80 years
Gender: Male

3.8 cm mass occupying virtually whole of the prostate gland, primarily on the left side with avid diffusion restriction. This extends beyond the prostatic capsule into the left mesorectal fat with 5 mm of mural invasion of the rectum between 12 and 3 o'clock.

6 mm right obturator node (small but round). No iliac lymphadenopathy.

Widespread metastases in the pelvis and spine. 

Small fatty right inguinal hernia.

Following the MRI spine, PSA was requested. PSA 1408 micrograms/L

Case Discussion

A T4 N1 M1b prostate malignancy. The tumor invades the rectum giving a T4 stage.

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