I had a colonoscopy that showed a Stage 1 cancer which they removed. The odds were less than 1 percent that I would get a reoccurrence. I decided to have a colon resection and 12 inches of my colon was removed. My PSA was 4.2 at that time. After this procedure, my PSA continued to elevate. Two years later when after watching it slowly rise I went for a biopsy and had the following result at Stanford. I am trying to see if I am a candidate for Proton Therapy at Loma Linda.
The prostate is mildly enlarged measuring 5.2 x 3.3 x 3.0 cm, with volume of 26.9 mL.
There is a 15 x 9 mm ill-defined T2 hypointense lesion within the right peripheral zone of the prostate gland (series 5 image 9) [PI-RADSv1 T2 Score 2]. There is restricted diffusion at this site on ADC with strong correlate on DWI [PI-RADSv1 ADC Score 5] (series 200 image 16, ADC measurement 730 mm 2/s). There is focal arterial phase enhancement on dynamic contrast examination that plateaus on venous phases [PI-RADSv1 DCE Score 4]. This lesion has a sum score of 11, for a PI-RADSv1 classification of this lesion as category 4 (clinically significant cancer is likely to be present). This lesion has a PI-RADSv2 classification of category 5 (clinically significant cancer is highly likely to be present).
There is a 9 x 9 mm ill-defined T2 hypointense lesion within the left anterior peripheral zone of the prostate gland (series 5 image 9) [PI-RADSv1 T2 Score 2]. There is restricted diffusion at this site on ADC with weak correlate on DWI [PI-RADSv1 ADC Score 4] (series 200 image 16, ADC measurement 665 mm 2/s). There is asymmetric arterial phase cancer isenhancement on dynamic contrast examination that is persistent on venous phases [PI-RADSv1 DCE Score 1]. This lesion has a sum score of 7, for a PI-RADSv1 classification of this lesion as category 3 (clinically significant cancer is equivocal). This lesion has a PI-RADSv2 classification of category 4 (clinically sign cancer is likely to be present).
The remainder of the peripheral zone demonstrates uniform high signal intensity on T2 without additional abnormalities on diffusion or postcontrast imaging [PI-RADSv1 1, likely benign].
The central gland demonstrates a well encapsulated whorled appearance, consistent with benign prostatic hyperplasia [PI-RADSv1 1, likely benign].
No evidence of extracapsular extension, involvement of the neurovascular bundles, or seminal vesicle invasion.
REMAINING PELVIS:Bowel: Visualized bowel is normal.
Bladder: a Moderately trabeculated appearance of the bladder.
Vasculature: Visualized iliac vessels are normal in caliber and patent.
Lymph nodes: No enlarged lymph nodes in the visualized pelvis.
Peritoneal space: No free fluid in the pelvis.
Musculoskeletal: Redemonstration of a hemangioma within the L5 Vertebral body. Several sacral Tarlov cysts are noted.
There is no component information for this result.
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