The ExactVU microultrasound (microUS) (Exact Imaging, Markham, ON, Canada) is a novel imaging modality that incorporates a standardized lesion classification system known as Prostate Risk Identification using Micro-Ultrasound (PRIMUS) to detect prostate cancer lesions. Here, we report a case of a 65-year-old patient diagnosed with Gleason 5+4 acinar adenocarcinoma with focal signet ring-like (mucinous) features identified on microUS that was not visualized on multiparametric magnetic resonance imaging (mpMRI). This case highlights microUS as a promising tool to improve cancer detection when used in conjunction with mpMRI, as well as the need for further research regarding unconventional prostate cancer histologic variants.
Cureus. 2026 Apr 22*** epublish ***
Kevin D Healey, James Blatchford, Shimron Brown, Emma Fenner, Phillip Latham, Nikhil Gopal
Department of Urology, The University of Tennessee Health Science Center, Memphis, USA., College of Medicine, The University of Tennessee Health Science Center, Memphis, USA.