Prostate metastases - widespread

Discussion:

This 80-year-old man with known metastatic prostate carcinoma was receiving radiotherapy to left hemipelvis.  

Diffuse bowel wall thickening involving the rectum, sigmoid colon and distal colon consistent with radiation colitis in the setting of radiation to the region.  There is prominence of the large bowel and small bowel loops which may reflect a degree of functional obstruction.  Skeletal lesions, liver lesions and multiple lung lesions are noted.  This is somewhat unusual for prostate cancer but can occur.  

An additional unusual finding is that of several small well-defined low-density nodules seen within the valvulae conniventes of small bowel loops that may represent metastases from the primary is considered, although this is very unusual and other non-malignant lesions such as small polyps can be considered. 

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