Prostate carcinoma (T4N1)

Case contributed by Bahman Rasuli


PSA 48 ng/mL. Hard prostate on rectal exam.

Patient Data

Age: 75 years
Gender: Male

The prostate measures 34 x 36 x 44 mm (26 g).

Loss of normal T2 high signal intensity of the peripheral zone, replaced by a T2 hypointense lesion, breaching the prostatic capsule, invading the left neurovascular bundle, and involving the left seminal vesicle and the base of the right seminal vesicle. Invasion to the trigone of the bladder and involvement the left ureteric orifice causing obstruction of the left ureter also seen.

Extensive iliac lymphadenopathy with maximum SAD of 10 mm.


The lesion was confirmed as prostate adenocarcinoma by biopsy.

Case Discussion

This case shows an already histologically proven bilateral prostate cancer in a patient who had been receiving androgen deprivation therapy (ADT). MRI was done for radiation therapy planning and staging purposes.

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