CPB Ljubljana 2018 course book

Male 72 years

Past history

10 years ago myocardial infarction followed by PTCA (percutaneous transluminal angioplasty). Since

then no heart related problems.

Since 3 years increasing PSA. Prior biopsies showed no malignancy. Last PSA 13.0 ng/ml.

Transrectal ultrasound: No hypo-echogeneic lesion. Capsule not invaded. Seminal vesicles show no

abnormality.

MRI: Right lobe no malignancy. Left transition zone 1.5 cm large suspected lesion. Seminal vesicles

not involved.

Prostate biopsy: Right lobe no malignancy. Left lobe 1/5 biopsy adenocarcinoma, Gleason 3 + 4 = 7

(Grade Group 2)

IPSS: 2

Qmax: 20.9 ml/s

Postvoiding residual volume 55 ml.

Voided volume: 189 ml

Medication: Acetylsalicylic acid, metoprolol, atorvastatine

Stage

T2aN0M0

Proposed treatment

I-125 implant

Task

Contour:

Prostate gland

CTV

Optional:

Rectum, urethra