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학습 자료 둘러보기 →A hard, fixed nodule on digital rectal examination (DRE) is a pathognomonic finding for extracapsular extension of prostate cancer. This signifies tumor adherence to structures like the seminal vesicles or pelvic sidewall, ruling out organ-confined disease.
Immediate action is required: urgent urological referral for confirmatory biopsy. Do not delay reporting to monitor lower urinary tract symptoms or repeat PSA testing, as this physical finding independently upstages the disease.
Differentiate from a benign, smooth, rubbery enlargement (BPH). A PSA level of 8.0 ng/mL or symptoms like hesitancy and nocturia are non-specific and do not carry the same immediate alarm for invasive malignancy as a fixed nodule.
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