Appropriate Planning Prior to Prostatectomy - Renal and Urology News

Appropriate Planning Prior to Prostatectomy

Slideshow

  • Multiparametric MRI scans of the prostate performed in a patient with high risk prostate cancer.

    Slide

    Multiparametric MRI scans of the prostate performed in a patient with high risk prostate cancer.

  • Slide

    Multiparametric MRI scans of the prostate performed in a patient with high risk prostate cancer.

  • Multiparametric MRI scans of the prostate performed in a patient with high risk prostate cancer.

    Slide

    Multiparametric MRI scans of the prostate performed in a patient with high risk prostate cancer.

A 63-year-old man with a PSA level of 6.3 ng/mL and a markedly abnormal digital rectal exam (diffuse firm nodularity throughout prostate) underwent 12-core template transrectal prostate needle biopsy, the results of which revealed Gleason 4+4=8 and Gleason 4+5=9 disease in 7 of 12 cores. The patient is motivated to proceed with surgical resection. As part of the staging work-up, you order a multiparametric magnetic resonance imaging (MRI) scan of the pelvis. Imaging findings are shown.

This case was prepared by Alexander Kutikov, MD, of Fox Chase Cancer Center in Philadelphia.Invisible text to push it down. Invisible text to push it down. Invisible text to push it down. Invisible text to push it down. Invisible text...

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This case was prepared by Alexander Kutikov, MD, of Fox Chase Cancer Center in Philadelphia.

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Answer: B

The MRI scans show gross invasion into the rectal wall. Generally, prostatectomy is not advisable in patients with this finding.

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