Background: A 59-year-old man on exogenous androgen therapy presented with a clinically palpable prostate nodule confined to one lobe on endorectal examination. Serum prostate-specific antigen was 3.4 ng/ml. Bone scintigraphy and baseline CT were reportedly negative.

Investigations: Physical examination, laboratory evaluation, endorectal MRI of the prostate, cystoscopy and biopsy.

Diagnosis: Poorly differentiated adenocarcinoma of the prostate, with invasion of the urinary bladder.

Management: Neoadjuvant hormonal therapy, followed by radiation.

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http://dx.doi.org/10.1038/ncpuro0328DOI Listing

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