Prostate cancer (ultrasound)

Case contributed by Mr. Dennis Odhiambo Agolah

Presentation

Metastatic prostate cancer with persistent hematuria. Patient on chemo-radiotherapy management.

Patient Data

Age: 75 years
Gender: Male
Ultrasound

An extensively large heterogeneous, irregularly outlined and hypervascular prostatic tumor that continues and is inseparable from the prostate gland inferiorly that progresses superiorly and fills three-quraters of the urinary bladder lumen is noted.  The lesion, including the prostate gland, measures approximately 523 grams (trans-abdominally) and is peripherally lobulated.  The pre-micturition bladder capacity of 146 cc and the immediate post-void bladder volume of 60 cc.

Unilateral right-sided hydroureteronephrosis (grade III). No gross pelvic adenopathy sonographically. 

Case Discussion

Diffuse and extensive globular enlargement of the prostate gland with bladder invasion in a patient with known prostate cancer presents with persistent hematuria with the patient unable to control the urge to void and maximally only able to hold up to 146 cc pre-void volume. There is unilateral right-sided ureterohydronephrosis (grade III). Bilateral percutaneous nephrostomy catheter tubes are noted in situ bilaterally.

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