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