[Atypical contrast enhancement in mucinous prostate cancer : Limitations of the PI-RADS (Prostate Imaging Reporting and Data System) classification and implications for modern imaging].

Abstract

Mucinous prostate carcinoma (mucPCa) often evades detection by prostate-imaging reporting and data system (PI-RADS)-based multiparametric magnetic resonance imaging (MRI). We report a case in which atypical dynamic contrast kinetics served as the sole imaging clue leading to the diagnosis of aggressive mucPCa. Neither T2-weighted nor diffusion-weighted sequences suggested malignancy. Only a targeted MRI/ultrasonography (US) fusion biopsy confirmed an International Society of Urological Pathology (ISUP) grade 4 mucPCa. This case underscores the diagnostic limitations of standardized imaging protocols and highlights the critical importance of contrast enhancement in rare histological subtypes.