73-year-old man 10 years after radical prostatectomy for Gleason 7 (4 + 3) tumor of pathologic stage pT3A, with left extracapsular extension but no seminal vesicle invasion. Follow-up showed biochemical recurrence with elevated prostate-specific antigen level of 2.17 ng/mL.
A, Transverse T2-weighted image shows 20-mm soft-tissue mass (arrow) suggestive of local recurrence located retrovesically in residual tissue of left seminal vesicle.
B and C, On contrast-enhanced MRI 1 minute (B) and 3 minutes (C) after injection, clear enhancement (arrows) could be seen. Transrectal ultrasound–guided biopsy verified Gleason score 7 local recurrence.