MRI-guided pelvic lymph node biopsy via transrectal approach in prostate cancer

Lymph node assessment in prostate cancer is most commonly performed at the time of radical prostatectomy. We present the case of pre-operative pelvic lymph node sampling with the use of MRI/TRUS fusion-guided biopsy at the time of prostate biopsy. Lymph node pathology revealed metastatic, poorly differentiated prostate cancer, concurrent with Gleason 4 + 5 disease showing perineural invasion. The use of MRI fusion guided biopsy for nodal sampling may be an effective method pre-operative staging and treatment planning for prostate adenocarcinoma.