Case 258

History: A 68-year-old man with a remote history of a previously resected high-grade urothelial carcinoma in the renal pelvis was being observed and was undergoing urologic treatment for recurrent low-grade urothelial carcinoma of the bladder. During his most recent evaluation, he reported no specific symptoms and denied experiencing hematuria, dysuria, or abdominal pain. At routine surveillance magnetic resonance (MR) imaging of the abdomen and pelvis (images not shown), a lesion was noted in the peripheral zone of the prostate gland. The prostate-specific antigen level was elevated (7.51 ng/mL [normal range, 0.00-4.00 ng/mL]). The patient had no family history of prostate cancer and had never undergone prostate biopsy. MR imaging of the prostate with an endorectal coil was subsequently performed (Figs 1-3).