Unusual hyperechoic appearance of prostate cancer on transrectal ultrasonography

Br J Urol. 1992 Feb;69(2):169-74. doi: 10.1111/j.1464-410x.1992.tb15490.x.


A series of 157 patients with prostate cancer underwent transrectal ultrasonography prior to radical prostatectomy. In 112 patients (71.3%) the tumours appeared hypoechoic relative to the echo pattern of the normal peripheral zone; in 43 (27.4%) they appeared isoechoic, and in only 2 (1.3%) did they appear purely or predominantly hyperechoic. These 2 hyperechoic tumours were unusual ductal adenocarcinomas with central necrosis and dystrophic calcification within solid tumour nests, a pattern similar to that of comedo-carcinoma of the breast. Calcification within prostate cancer was found in 4 of the 157 radical prostatectomy specimens, including 2 other hypoechoic cancers which contained intraluminal or psammomatous calcification. Although the most common sonographic appearance of localised prostate cancer is hypoechoic, a predominantly hyperechoic pattern is seen occasionally and suggests the presence of a high grade ductal adenocarcinoma.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging*
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Humans
  • Male
  • Middle Aged
  • Prostate / diagnostic imaging*
  • Prostate / pathology
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / pathology
  • Ultrasonography