Prostate carcinoma (T4N1M1b)

Case contributed by Ian Bickle

Presentation

PSA 17.9. Hard prostate on rectal exam.

Patient Data

Age: 70 years
Gender: Male
mri

Extensive low T2 signal in the right lobe of prostate involving both the transitional and peripheral zones.  Corresponding b1400 change and avid ADC restriction.  This extends from the apex to base with extracapsular extension involving the neurovascular bundle and base of the right seminal vesicle. (PIRADS 5).

Extensive iliac lymphadenopathy.

Large metastasis in the right inferior pubic ramus.

Nuclear medicine

Intense tracer activity in the right inferior pubic ramus consistent with metastasis.

 

Case Discussion

High volume metastatic prostate carcinoma.

The MR demonstrates a large PIRADS 5 focus with identical changes in the metastatic iliac nodes.

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