Presentation
PSA 17.9. Hard prostate on rectal exam.
Patient Data
Age: 70 years
Gender: Male
From the case:
Prostate carcinoma (T4N1M1b)
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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.
From the case:
Prostate carcinoma (T4N1M1b)
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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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