Incidental periprostatic schwannoma discovered during evaluation for prostatic adenocarcinoma

Prostatic schwannoma discovered after laparoscopic radical prostatectomy: A case report with literature review

Background

Schwannomas originating in the prostate are extremely rare. We present a case of prostatic schwannoma in a 66-year-old male with lower urinary tract symptoms. Preoperative evaluation revealed a prostatic mass, and the definitive diagnosis was made through laparoscopic radical prostatectomy.

Case presentation

A 66-year-old male presented with persistent lower urinary tract symptoms for 5 years and a prostate-specific antigen level of 0.63 ng/mL. MRI showed a well-defined solid cystic mass in the posterolateral basal right peripheral zone, causing superior displacement of the right seminal vesicle. Laparoscopic radical prostatectomy was performed, confirming a periprostatic schwannoma.

Conclusion

This case highlights the rarity of prostatic schwannomas and their association with lower urinary tract symptoms. MRI plays a crucial role in identifying prostatic masses, while laparoscopic radical prostatectomy can serve as a diagnostic and therapeutic approach for prostatic schwannomas. Increased awareness of this rare entity is essential for accurate diagnosis and optimal management.

Locally advanced solitary fibrous tumour of the prostate

Solitary fibrous tumours (SFTs) are rare mesenchymal neoplasms composed of spindle cells, most often occurring in the pleura. SFTs arising from the prostate are exceptionally rare, with only around 40 cases reported in literature to date. We report a man in his 60s who was referred to our clinic for elevated prostate-specific antigen and presented with mild obstructive lower urinary tract and defecatory symptoms. Prostate needle-core biopsy revealed neoplastic spindle cells that strongly expressed CD34. Cross-sectional imaging demonstrated a 12 cm locally advanced heterogeneous prostate mass with intravesical extension and mass effect on the anterior rectum. Radical cystoprostatectomy with orthotopic neobladder reconstruction was performed, and the diagnosis of primary prostatic SFT was made based on histological characteristics and immunophenotyping. We present diagnostic, clinical management and prognostic considerations in patients with primary prostatic SFT.

Prostatic Schwannoma Presenting with Prostate-specific Antigen Elevation: A Case Report

Introduction: Schwannoma of the male genital system is very uncommon and is mostly treated by surgery. However, prostatic schwannoma presenting with elevated prostate-specific antigen (PSA) level and treated conservatively are extremely rare. Case presentation: Herein, we present a rare case of a prostatic schwannoma in a 65-year-old man who initially presented with an elevated PSA level. Digital rectal examination revealed an enlarged prostate with a palpable hard nodule on the left side. Transrectal ultrasonography revealed an enlarged prostate with a well-defined homogeneously hypoechoic nodule in the left peripheral lobe. Biopsy was done, and histopathology revealed a prostatic schwannoma. Conservative treatment with regular image follow-up was done per the patient's preference. Mild PSA progression but no worsening of symptoms was found in 6 years of follow-up. Conclusions: PSA elevation could be a rare presentation of prostatic schwannoma. Treatment options other than surgery, such as conservative treatment with close observation, could be feasible for these rare tumors and long-term survivorship can be achieved.

Periprostatic schwannoma mimicking metastatic lymphadenopathy in a case of multifocal prostate adenocarcinoma

Schwannomas of the prostate are a rare entity and usually diagnosed incidentally following surgical management of presumed benign prostate hyperplasia or prostate adenocarcinoma. We present a case of sporadic periprostatic schwannoma diagnosed in conjunction with multifocal prostate adenocarcinoma on pre-operative multiparametric magnetic resonance imaging.