Primary prostate synovial sarcoma: A case report and review of literature

Prostate stromal sarcoma mimicking benign prostate hyperplasia: A case report

INTRODUCTION & OBJECTIVES

Prostate stromal sarcoma is extremely rare and aggressive malignancy accounting for less than 1 % of all type of prostate cancers. It is frequently misdiagnosed from other lower urinary tract symptoms (LUTS) problems.

CASE PRESENTATION

We present a case report of 45-year-old male complaining with LUTS problems. Patient also suffers anorexia and weight loss. He was first diagnosed with benign prostate hyperplasia (BPH). Patients had done transurethral resection of prostate (TURP) to alleviate the complaint, but the symptoms worsened and recurred. Histopathological examination findings confirmed prostate stromal sarcoma (T4N0M0). Patient was further examined using MRI and then radical prostatectomy procedure was performed.

DISCUSSION

Incidence of prostate stromal sarcoma is very low and most commonly presents with obstructive LUTS symptoms. This could mimic other disease such as BPH or other type of prostate cancer. Therefore, clinicians require a high suspicion in patient with recurrent LUTS.

CONCLUSION

Prostate stromal sarcoma diagnosis is a challenging disease entity that necessitates histopathology examination. Timely and accurate diagnosis of prostate stromal sarcoma is needed to achieve better outcome and prognosis for the patients.

Primary synovial sarcoma and acinar adenocarcinoma of prostate rarely occur simultaneously: A case report

RATIONALE

Primary synovial sarcoma of the prostate is an extremely rare mesenchymal malignant soft tissue tumor with unique morphological features. Synovial sarcoma often occurs in the pararticular tissues of limbs in young people, but rarely occurs in prostate. Because it is very rare, it is easily misdiagnosed as benign prostatic hyperplasia or prostate cancer clinically. A case of synchronous acinar adenocarcinoma of the prostate has not been reported. In this article, we report a unique case of primary prostatic synovial sarcoma with acinar adenocarcinoma.

PATIENT CONCERNS

A 58-year-old male patient was found to have a prostate mass during physical examination. Prostate ultrasound examination showed an increase in prostate volume of 5.2 × 3.3 × 3.3 cm, mixed echo mass can be seen on the left side of the prostate, with a size of approximately 4.9 × 4.3 cm, left seminal vesicle compressed.

DIAGNOSES

Prostatic synovial sarcoma (biphasic type) combined with prostatic acinar adenocarcinoma (Gleason 3 + 3).

INTERVENTION

The patient received radical prostatectomy, followed by adjuvant chemotherapy and radiotherapy.

OUTCOME

After 2 months of follow-up, at the time of writing this article, the patient received a comprehensive treatment plan of adjuvant chemotherapy and radiotherapy for 2 months, and no recurrence or metastasis was found.

LESSONS

Primary prostatic synovial sarcoma (biphasic type) combined with prostatic acinar adenocarcinoma is a very unique and rare case, and effective treatment guidelines are not yet clear, posing new challenges to clinical treatment. Making full use of pathological and imaging examinations, early diagnosis and radical surgery combined with multidisciplinary treatment seem to be still a positive method.

Unusual Cause of Acute Urinary Retention in Young Male Patient: Primary Synovial Sarcoma of Prostate—A Case Report

Introduction  Primary synovial sarcoma (SS) of the prostate is the rarest variety of prostate sarcoma. The first documented and confirmed case of SS of the prostate was published by Iwasaki et al in the year 1999; since then, only a few cases of primary SS of the prostate have been published in English literature.

Case Report  We report a unique case of primary SS in a young patient who presented with acute urinary retention and underwent emergency suprapubic catheterization, and on evaluation was diagnosed with primary SS of the prostate. Patient was managed with radical cystoprostatectomy and resection of the anterior wall of rectum infiltrated by the tumor with bilateral pelvic lymph node dissection and adjuvant chemotherapy. Patient died after 2 months of surgery.

Conclusion  Primary SS of the prostate is a rare disease and important clinical entity to be included in differential diagnosis of acute urinary retention in young patients. It is associated with high local recurrence and poor prognosis, which warrants multidisciplinary approach of treatment.