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View full-text article in PMC

. 2021 Nov 11;13(22):5647. doi: 10.3390/cancers13225647

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© 2021 by the author.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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A 73-year-old man with high PSA (10.71 ng/mL): T2-weighted MR image (left figure) shows a PI-RADS 4 peripheral lesion (white arrow) in the left mid-gland. It is a 1.3 cm hypointense tumor in which the capsule (white arrowheads) is not disrupted, consistent with PI-RADS 4. Transrectal ultrasound image (right figure) shows it is a hypoechoic tumor (white arrow) with irregular or spiculate margin (black arrowheads). The capsule (white arrowheads) neighboring the tumor also appears thick and infiltrative, suggesting extra-capsular extension. Four target cores alone were obtained and systematic biopsy was skipped. The tumor was histologically confirmed adenocarcinoma GS 7 (4 + 3). The tumor shape looks more round on MRI than TRUS. Left peri-prostatic nerves were not saved because extensive capsular extension was detected during the robot-assisted radical prostatectomy.