There is a hypoechoic mass involving the upper hemicircumference of the image (9 o’clock to 3 o’clock position). The seminal vesicles and prostate are located at the 4 o’clock position. The mass extends through the muscularis propria and into the perirectal fat. There are also several round, hypoechoic, well-demarcated lymph nodes in the 11 o’clock to 1 o’clock position. This is consistent with an endoscopic ultrasound stage T3, N1 adenocarcinoma.