This case demonstrates a PI-RADS 5 lesion of the anterior transition zone.

Histology of the biopsy revealed a continuous infiltrate of an acinar adenocarcinoma (modified Gleason score 3+4=7a within one core and 4+5=9 within the other core.

The patient underwent radical retroperitoneal prostatectomy with pelvic lymphadenectomy.

Final histology of the prostatectomy preparation revealed adenocarcinoma in both lobes  (≈14%):  Gleason score 4+5=9, WHO grade 5.

Resection margins were free from tumor cells.

Tumorclassification: pT2c, pN0, R0.