Mixed acinar and macrocystic ductal prostatic adenocarcinoma

A 64-year-old man with a prostate-specific antigen (PSA) of 5·74 ng/mL, no lower urinary symptoms, and family history prostate cancer presented at our clinic University College London Hospital (London, UK) in April, 2018. Axial T2-weighted MRI the showed multicystic lesion (PSA density 0·07 ng/mL/mL), MRI-targeted biopsies Gleason 3 + adenocarcinoma (Gleason Grade Group 1) prostatic intraepithelial-like ductal features. The patient was offered either surgery or an MRI-led active surveillance pathway.