1
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Bettaieb O, Keskes A, Llacer Moscardo C. Leiomyosarcoma of the Prostate: Report of Two Cases and Review of the Literature. Case Rep Oncol 2024; 17:454-462. [PMID: 38455715 PMCID: PMC10919910 DOI: 10.1159/000535425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 11/20/2023] [Indexed: 03/09/2024] Open
Abstract
Introduction Leiomyosarcoma (LMS) of the prostate is an extremely rare and aggressive tumor that presents with nonspecific signs and symptoms. Treatment guidelines are not yet established. Case Presentation We report two cases of LMS of the prostate. The presenting symptom was hematuria, and diagnosis was ascertained through a transurethral resection of the prostate for the 2 patients. The treatment course consisted of three courses of chemotherapy with gemcitabine and docetaxel, radical prostatectomy, and postoperative radiation therapy for the first patient and three courses of gemcitabine and radiation therapy of the prostate and the whole pelvis for the second patient. The follow-up of our 2 patients was 9 and 12 months, respectively. Recurrence occurred 10 months after treatment completion for the second case. No recurrence was noticed in the first case. Conclusion These two cases highlight the importance of a multimodal approach to yield the best outcomes.
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Affiliation(s)
- Ons Bettaieb
- Radiation Oncology Department, Farhat Hached Hospital, University of Sousse, Sousse, Tunisia
| | - Aicha Keskes
- Montpellier Cancer Institute, Federation of Radiation Oncology of Mediterranean Occitanie, University Montpellier, INSERM U1194 IRCM, Montpellier, France
| | - Carmen Llacer Moscardo
- Montpellier Cancer Institute, Federation of Radiation Oncology of Mediterranean Occitanie, University Montpellier, INSERM U1194 IRCM, Montpellier, France
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2
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Jaouani L, Zaimi A, Al Jarroudi O, Brahmi SA, Afqir S. Undifferentiated Sarcoma: A Rare Tumor of the Prostate. Cureus 2023; 15:e41056. [PMID: 37519507 PMCID: PMC10374467 DOI: 10.7759/cureus.41056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Prostate cancer is the most common malignant tumor in men. The vast majority of prostate tumors are represented by prostatic adenocarcinomas (up to 95%). Sarcoma is a very rare tumor in adults with a formidable prognosis. Early diagnosis and radical surgery offer patients the best chance of a cure. We report the case of a 44-year-old patient with stage VI unresectable high-grade undifferentiated prostate sarcoma, initially presenting with urinary disorders and a large pelvic mass of prostatic origin, with normal Prostate-specific antigen (PSA) levels. The patient was managed by palliative chemotherapy.
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Affiliation(s)
- Laila Jaouani
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
| | - Adil Zaimi
- Medical Oncology, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR
| | | | | | - Said Afqir
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
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3
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Bkiri S, Tlemsani Z, Khdach Y, Bennani K, Abbad F, Ghadouane M. Can pelvic radiotherapy induce a leiomyosarcoma of the prostate? (A case report). Pan Afr Med J 2022; 43:56. [PMID: 36578814 PMCID: PMC9755551 DOI: 10.11604/pamj.2022.43.56.36997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/28/2022] [Indexed: 11/29/2022] Open
Abstract
Leiomyosarcoma of the prostate is an extremely rare neoplasm. It represents less than 0.1% of all prostate malignancies. It is considered to have a poor prognosis, an aggressive nature, and high metastatic potential. Additionally, the relationship between radiation exposure for the treatment of primary prostatic cancer and the occurrence of leiomyosarcoma as second cancer at the irradiated site is rare, with unknown etiology. We reported a 72-year-old male known case of prostate adenocarcinoma with radio-hormonotherapy for six years who presented with acute urinary retention. Magnetic resonance imaging revealed a large malignant obstructive prostate with direct invasion of surrounding organs and multiple metastases. Trans-urethral resection of the prostate was performed, and the histopathology result showed high-grade leiomyosarcoma. The patient passed away after four months due to multiorgan failure. In conclusion, there may be a causal relationship between radiation therapy to the prostate and the development of prostate leiomyosarcoma.
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Affiliation(s)
- Saad Bkiri
- Urology Department, Cheikh Zaid International Hospital, Abulcasis International University, Rabat, Morocco,,Corresponding author: Saad Bkiri, Urology Department, Cheikh Zaid International Hospital, Abulcasis International University, Rabat, Morocco.
| | - Zakaria Tlemsani
- Urology Department, Cheikh Zaid International Hospital, Abulcasis International University, Rabat, Morocco
| | - Youness Khdach
- Urology Department, Cheikh Zaid International Hospital, Abulcasis International University, Rabat, Morocco
| | - Karim Bennani
- Urology Department, Cheikh Zaid International Hospital, Abulcasis International University, Rabat, Morocco
| | - Fayçal Abbad
- Histopathology Department, Cheikh Zaid International Hospital, Abulcasis International University, Rabat, Morocco
| | - Mohammed Ghadouane
- Urology Department, Cheikh Zaid International Hospital, Abulcasis International University, Rabat, Morocco
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4
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Kawaguchi T, Tanaka T, Ogasawara M, Ikuya I. Long-term disease control after upfront chemotherapy and surgery in a patient with primary prostate leiomyosarcoma. IJU Case Rep 2022; 5:88-91. [PMID: 35252786 PMCID: PMC8888012 DOI: 10.1002/iju5.12400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Prostate leiomyosarcoma is a rare, aggressive neoplasm. CASE PRESENTATION A 52-year-old man presented with worsening frequent micturition and painful urination. Rectal examination revealed a significantly enlarged prostate. Magnetic resonance imaging showed a large prostate tumor with urinary bladder and bilateral seminal vesicle invasion. A prostate biopsy revealed diffuse proliferation of pleomorphic atypical cells. Immunohistochemistry confirmed the diagnosis of prostrate leiomyosarcoma. The patient received three cycles of the mesna, doxorubicin, ifosfamide, and dacarbazine regime (mesna 6000 mg/m2, doxorubicin 60 mg/m2, ifosfamide 7500 mg/m2, and dacarbazine 900 mg/m2) at 4-week intervals. The tumor shrank by 28% and exhibited necrotic changes. He underwent total pelvic exenteration with en bloc resection of the prostate, bladder, rectum, and anus. Pathological surgical margin was negative. The patient is alive with no disease at 5 years postoperatively. CONCLUSION Neoadjuvant chemotherapy and surgical resection are essential to achieve a long-term survival of patients with localized prostate leiomyosarcoma.
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Affiliation(s)
- Toshiaki Kawaguchi
- Department of UrologyAomori Prefectural Central HospitalAomori‐shiAomoriJapan
| | - Toshikazu Tanaka
- Department of UrologyAomori Prefectural Central HospitalAomori‐shiAomoriJapan
| | - Masaru Ogasawara
- Department of UrologyAomori Prefectural Central HospitalAomori‐shiAomoriJapan
| | - Iwabuchi Ikuya
- Department of UrologyAomori Prefectural Central HospitalAomori‐shiAomoriJapan
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5
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Management of Leiomyosarcoma of the Prostate: Unraveling a Hoax. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2021. [DOI: 10.1016/j.cpccr.2021.100068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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6
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Shen Q, Zhou Z, Liu Z, Hu S, Lin Z, Li S, Li S, Song H, Chen Y, Meng Y, Wang Y, Fan Y, Li X, Xiao Y, He Q, Jin J, Zhang Q, Yu W. Clinical and Pathological Features of Prostatic Stromal Tumor of Uncertain Malignant Potential: A Retrospective Study of 23 Chinese Cases. Urol Int 2020; 105:206-214. [PMID: 33221793 DOI: 10.1159/000508763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 05/16/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Prostatic stromal tumor of uncertain malignant potential (STUMP) is a rare disease that may coexist with prostate stromal sarcoma (PSS). We aimed to analyze the histological and clinical features of STUMP. METHODS Twenty-three patients diagnosed with STUMP from 2008 to 2019 were included. Clinicopathological and follow-up information was collected. In the subgroup analysis, we divided the patients into a pure STUMP group (N = 18) and a mixed STUMP (STUMP coexisting with PSS) group (N = 5). Student's t test was used to compare the 2 groups. RESULTS Patients had a mean age of 55.5 ± 19.4 years and an average follow-up time of 42.3 months. The mean prostate volume was 109.2 ± 73.5 cm3, and the mean prostate-specific antigen was 8.03 ± 10.5 ng/mL. In the subgroup analysis, 16.7% (2/12) of pure STUMP patients had disease progression, while 100% (3/3) of mixed STUMP patients suffered from recurrence. Compared with the pure STUMP group, the mixed STUMP group was younger (37.2 vs. 60.6 years, p = 0.013) and had lower expression of estrogen receptor and progesterone receptor (p = 0.004 and p < 0.001, respectively). CONCLUSION STUMP is a rare disease with a relatively good prognosis. However, there is still a possibility of disease progression or coexistence with stromal sarcoma. Timely diagnosis and regular monitoring may be helpful in improving treatment outcomes.
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Affiliation(s)
- Qi Shen
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China.,Department of Urological Pathology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Zhaohui Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Zhenhua Liu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Shuai Hu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China.,Department of Urological Pathology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Zhiyong Lin
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Shaobo Li
- School of Basic Medicine, Fudan University, Shanghai, China
| | - Senmao Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Hualin Song
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Yuke Chen
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Yisen Meng
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Yu Wang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Yu Fan
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Xin Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Yunxiang Xiao
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Qun He
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China.,Department of Urological Pathology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Jie Jin
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
| | - Qian Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China,
| | - Wei Yu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Research Center for Genitourinary Oncology, Beijing, China
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7
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Ding B, Zhang Y, Hu W, Hu D, Liu J, Zhao S, Wang F, Xue L, Xu Z, Chen L. Adult primary prostate sarcoma: A multi-center cohort study and comparison between Chinese and American cases. Asian J Surg 2020; 44:247-253. [PMID: 32636119 DOI: 10.1016/j.asjsur.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 05/29/2020] [Accepted: 06/07/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND/OBJECTIVES To assess the effects of clinical factors and treatments on the overall survival (OS) of patients with prostate sarcomas. METHODS We reported 41 cases diagnosed with prostate sarcomas from eight hospitals in China and retrospectively analyzed the prognostic factors by combining our data with cases from five previously published cohorts, including one extra Chinese cohort and four cohorts from US cohorts. Additionally, we investigated the differences in treatment regimens between China (n = 66) and the USA (n = 74). RESULTS The median survival time of the 41 cases was 18.6 months (95% confidence interval [CI]: 13.9-23.2). The status of negative distant metastasis (P = 0.004) and radical tumor resection with negative margin (P = 0.001) were significantly associated with better overall survival, whereas age, tumor size, duration of initial symptoms, and chemo/radiotherapy were not significantly related to OS. The survival time was longer in patients with rhabdomyosarcoma than in those with leiomyosarcoma (P = 0.049). Combined analysis of the current and 5 prior cohorts showed that more patients in the US cohorts underwent radical surgery (P = 0.005), and the overall survival was better among those with radical cystoprostatectomy compared to those with radical prostatectomy alone (P = 0.008). CONCLUSION Radical resection to achieve a negative margin contributes to better survival for patients with prostate sarcoma.
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Affiliation(s)
- Beichen Ding
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China; Department of Urology Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 15001, China
| | - Yucong Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Wei Hu
- Department of Urology, Hubei General Hospital, Wuhan University, Wuhan, 430060, China
| | - Dongliang Hu
- Department of Urology, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China
| | - Jianjun Liu
- Department of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524000, China
| | - Shanchao Zhao
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Fei Wang
- Department of Urology, Hainan General Hospital, Haikou, 570311, China
| | - Li Xue
- Department of Urology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Zhanping Xu
- Department of Urology, Guangdong General Hospital, Guangzhou, 510080, China
| | - Liang Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China.
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8
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Wang MQ, Zhang JL, Yuan K, Yuan B, Duan F, Yan JY, Wang Y, Fu JX. Large inoperable leiomyosarcoma of the prostate: treated by transcatheter arterial chemoembolization with drug-eluting microspheres. Ther Adv Med Oncol 2020; 12:1758835920917573. [PMID: 32489428 PMCID: PMC7238308 DOI: 10.1177/1758835920917573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/13/2020] [Indexed: 12/17/2022] Open
Abstract
Background Prostatic leiomyosarcoma (LMS) has a poor prognosis with a median overall survival (OS) of 15-18 months. For patients with metastatic disease, radical surgical resection, with or without adjuvant systemic chemotherapy and radiation therapy, unfortunately provides limited therapeutic benefit. Novel approaches for this lethal disease are urgently needed. Objectives To evaluate the feasibility and efficacy of transarterial chemoembolization (TACE) with doxorubicin-eluting HepaSpheres (HS) for inoperable LMS of the prostate. Methods This case series included 12 patients (median age 57 years, range 32-74) with inoperable LMS of the prostate who were treated with TACE using doxorubicin-eluting HS. All patients were pathologically proved by fine-needle biopsy. Symptomatic relief, complications, OS, and local disease control based on modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria were evaluated. Results Symptomatic relief, including control of the gross hematuria, removal of indwelling catheters, improvement of constipation and perineal pain, were obtained in 100%, 75%, 100%, and 86%, respectively after TACE, without any major complications. At the last follow-up after TACE, the percentage of the tumor necrosis and volume reduction were present with a median value of 90% and 84%, respectively. TACE after two to four sessions allowed subsequent surgical resection in five (41.7%) patients. The median follow-up time was 29 months; the survival rate at 1, 2, and 3 years was 91.7%, 83.3%, and 41.7%, respectively, and the median OS was 29 months (range 9-49 months). Conclusions TACE of inoperable LMS of the prostate appears to be safe and effective in providing tumor necrosis, shrinkage, and symptom relief; that could improve the quality of life and the survival rate of these patients.
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Affiliation(s)
- Mao Qiang Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd., Beijing 100853, P.R. China
| | - Jin Long Zhang
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Kai Yuan
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Bing Yuan
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Feng Duan
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Jie Yu Yan
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Yan Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Jin Xin Fu
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
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9
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Whish-Wilson T, Wong LM, Hendry S, Ng M, Pang G, Sutherland T. Prostate sarcomas: A radiological mimic for benign prostatic hyperplasia. Urol Case Rep 2020; 31:101192. [PMID: 32300534 PMCID: PMC7152657 DOI: 10.1016/j.eucr.2020.101192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 11/13/2022] Open
Abstract
Leimyosarcomas arising from the stroma of the prostate are very rare, accounting for 0.1% of malignancies. We describe a case that closely mimicked benign prostatic hypertrophy on magnetic resonance imaging. Due to the low incidence of disease there is no high level evidence for management. We advocate neoadjuvant radiotherapy followed by radical prostatectomy with pelvic lymph node dissection. Diagnosis and expedient management is critical. Sarcomas of the prostate may mimic benign nodules on MRI. Sarcomas of the prostate are rare but highly aggressive. Sarcomas of the prostate should recieve neoadjuvant radiotherapy before radical prostatectomy with bilateral pelvic lymph node dissection.
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Affiliation(s)
- Thomas Whish-Wilson
- Department of Surgery, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, Victoria, 3065, Australia.,Department of Surgery, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Lih-Ming Wong
- Department of Surgery, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, Victoria, 3065, Australia.,Department of Surgery, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Shona Hendry
- Department of Pathology, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, Victoria, 3065, Australia
| | - Michael Ng
- Genesis Care, Radiation Oncology, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, Victoria, 3065, Australia
| | - Grant Pang
- Department of Surgery, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, Victoria, 3065, Australia
| | - Tom Sutherland
- Medical Imaging Department, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, Victoria, 3065, Australia.,Department of Medicine, University of Melbourne, Parkville, Victoria, 3010, Australia
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10
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Alves LJ, Gameiro CD, Lopes SP, Ascensão JDB, Sousa RC. Prostate Leiomyosarcoma: A Rare Misleading Tumor. Urology 2019; 130:13-16. [DOI: 10.1016/j.urology.2019.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 03/30/2019] [Accepted: 04/09/2019] [Indexed: 12/01/2022]
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11
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Ermann DA, Noble VV, Fazeel HM, Thomas B, Silberstein PT. Presentation of a Rare Malignancy: Leiomyosarcoma of the Prostate. Fed Pract 2019; 36:S30-S33. [PMID: 30867634 PMCID: PMC6411357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Prostatic leiomyosarcoma is an aggressive malignancy with a high risk of metastasis and a poor prognosis that poses unique diagnostic and treatment challenges.
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Affiliation(s)
- Daniel A Ermann
- is an Internal Medicine Resident; and are Medical Students; is a Graduate Student; and is Chief of Hematology/Oncology; all at Creighton University Medical Center in Omaha, Nebraska
| | - Victoria V Noble
- is an Internal Medicine Resident; and are Medical Students; is a Graduate Student; and is Chief of Hematology/Oncology; all at Creighton University Medical Center in Omaha, Nebraska
| | - Hafiz M Fazeel
- is an Internal Medicine Resident; and are Medical Students; is a Graduate Student; and is Chief of Hematology/Oncology; all at Creighton University Medical Center in Omaha, Nebraska
| | - Brittany Thomas
- is an Internal Medicine Resident; and are Medical Students; is a Graduate Student; and is Chief of Hematology/Oncology; all at Creighton University Medical Center in Omaha, Nebraska
| | - Peter T Silberstein
- is an Internal Medicine Resident; and are Medical Students; is a Graduate Student; and is Chief of Hematology/Oncology; all at Creighton University Medical Center in Omaha, Nebraska
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12
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Keske M, Canda AE, Atmaca AF, Bedir F, Gecit I, Ardicoglu A, Aydogdu OB, Agackiran Y, Ocal BG. A Large Posteriorly Located Prostatic Mass Lesion Challenging the Robotic Surgeon: Prostate Leiomyoma. J Endourol Case Rep 2017; 3:61-63. [PMID: 28560353 PMCID: PMC5446627 DOI: 10.1089/cren.2017.0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Prostatic leiomyoma is a benign and rare condition of the prostate. Robotic surgery is increasingly being applied in the surgical management of prostate cancer. Case Presentation: Herein, a mass lesion that was located in the posterior part of the prostate between seminal vesicles that was identified during robotic surgery is presented. This lesion further challenged the console surgeon during performing a robotic radical prostatectomy procedure for a 200 g large prostate with prostate cancer. Conclusion: Prostatic leiomyomas that are benign mesenchymal smooth muscle tumors might present as a posteriorly located mass lesion between seminal vesicles that could challenge the surgeon during surgery, which should be kept in mind.
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Affiliation(s)
- Murat Keske
- Department of Urology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Abdullah Erdem Canda
- Department of Urology, Ankara Ataturk Training and Research Hospital, Yildirim Beyazit University, School of Medicine, Ankara, Turkey
| | - Ali Fuat Atmaca
- Department of Urology, Ankara Ataturk Training and Research Hospital, Yildirim Beyazit University, School of Medicine, Ankara, Turkey
| | - Fevzi Bedir
- Department of Urology, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Ilhan Gecit
- Department of Urology, Inonu University, School of Medicine, Malatya, Turkey
| | - Arslan Ardicoglu
- Department of Urology, Ankara Ataturk Training and Research Hospital, Yildirim Beyazit University, School of Medicine, Ankara, Turkey
| | - Ozge Basaran Aydogdu
- Department of Pathology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Yetkin Agackiran
- Department of Pathology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Berrak Gumuskaya Ocal
- Department of Pathology, Ankara Ataturk Training and Research Hospital, Yildirim Beyazit University, School of Medicine, Ankara, Turkey
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13
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Mitra S, Kaur G, Kakkar N, Singh P, Dey P. Sarcoma in urine cytology; an extremely rare entity: A report of two cases. J Cytol 2017; 34:171-173. [PMID: 28701835 PMCID: PMC5492759 DOI: 10.4103/0970-9371.208100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Primary sarcomas of the urinary bladder or prostate are extremely rare entities. The rarity and lack of awareness makes it difficult for the cytologists to detect the spindle cell lesions in urine for malignant cytology. The literature available for the detection of urinary tract sarcomas is little. Here, we report the urine cytology findings of two interesting cases of urinary bladder and prostatic leiomyosarcoma.
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Affiliation(s)
- Suvradeep Mitra
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Gurwinder Kaur
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nandita Kakkar
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Priya Singh
- Department of Cytopathology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranab Dey
- Department of Cytopathology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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14
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Raj DH, Dash PK, Mohanty J, Sarangi PK. Leiomyosarcoma of the prostate-an unexpected histopathological outcome. BMJ Case Rep 2016; 2016:bcr-2016-215594. [PMID: 27284101 DOI: 10.1136/bcr-2016-215594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Prostate leiomyosarcoma is an extremely rare and highly aggressive neoplasm that accounts for >0.1% of all primary prostate malignancies. We report a case of a patient, presenting with recurrent episodes of dysuria, who had been diagnosed and operated for benign prostatic hyperplasia 1 month earlier, and now presented with similar symptoms postoperatively. Trans-rectal biopsy of the prostate was carried out and histopathology revealed leiomyosarcoma of the prostate.
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Affiliation(s)
- Dinesh Harvey Raj
- Department of Radiodiagnosis, SCB Medical College, Cuttack, Odisha, India
| | - Prafulla Kumar Dash
- Department of Radiodiagnosis, CMIIL-SCB Medical MRI Centre, Cuttack, Odisha, India
| | - Jayashree Mohanty
- Department of Radiodiagnosis, SCB Medical College, Cuttack, Odisha, India
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15
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Chen W, Han DJ, Fu GQ, Lin W, Liang Y. Long term follow-up of surgery management of prostate leiomyosarcoma metastasized to the rib: A case report and literature review. Mol Clin Oncol 2016; 5:132-134. [PMID: 27330784 DOI: 10.3892/mco.2016.898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/01/2016] [Indexed: 11/05/2022] Open
Abstract
Prostate sarcoma, particularly the pathological type of leiomyosarcoma, is a rare carcinoma, which originated from the interstitial tissue of the prostate. This sarcoma type has a poor prognosis. This disease accounts for ~0.1% of all prostate cancer and it usually occurrs in patients aged between 40 and 78-years-old. Although prostate leiomyosarcoma has a poor prognosis, early treatment of post-operative recurrence and metastases via a whole-body examination and closer follow-up was possible. These measurements may significantly prolong the survival time and improve the quality of life. The present study reported a successful case of surgical management for prostate leiomyosarcoma in the Zigong No. 4 People's Hospital (Sichuan, China) during 1995 until 2015, with post-operative follow-up for 20 years.
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Affiliation(s)
- Wei Chen
- Department of Urology, Zigong No. 4 People's Hospital, Zigong, Sichuan 643000, P.R. China
| | - Deng-Jun Han
- Department of Urology, Zigong No. 4 People's Hospital, Zigong, Sichuan 643000, P.R. China
| | - Guang-Qing Fu
- Department of Urology, Zigong No. 4 People's Hospital, Zigong, Sichuan 643000, P.R. China
| | - Wei Lin
- Department of Urology, Zigong No. 4 People's Hospital, Zigong, Sichuan 643000, P.R. China
| | - Yong Liang
- Department of Urology, Zigong No. 4 People's Hospital, Zigong, Sichuan 643000, P.R. China
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16
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A Review of the Literature on Primary Leiomyosarcoma of the Prostate Gland. Adv Urol 2015; 2015:485786. [PMID: 26640482 PMCID: PMC4659954 DOI: 10.1155/2015/485786] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/24/2015] [Accepted: 10/04/2015] [Indexed: 12/20/2022] Open
Abstract
Primary leiomyosarcoma of the prostate (PLSOP) is rare, with less than 200 cases reported so far. PLSOPs present with lower urinary tract symptoms, haematuria, and perineal pain; may or may not be associated with a history of previous treatment for adenocarcinoma of prostate by means of radiotherapy and or hormonal treatment; may afflict children and adult male. Examination may reveal benign enlarged prostate and hard enlarged mass. PLSOPs may be diagnosed by histological examination findings of spindle-shaped carcinoma cells in prostate specimens. Immunohistochemical staining tends to be positive for vimentin, CD44, smooth muscle actin, and calponin, focally positive for desmin, and at times positive for keratin. They stain negatively for PSA, S-100, CD34, CD117, and cytokeratin. Cytogenetic study on primary leiomyosarcoma of the prostate gland may show clonal chromosomal rearrangement involving Chromosomes 2, 3, 9, 11, and 19. On the whole the prognosis is poor. Surgery with or without chemotherapy would appear to be the mainstay of treatment for PLSOPs that are operable, but generally there is no consensus opinion on the best therapeutic approach. Most cases of PLSOPs are diagnosed in an advanced stage of the disease. A global multicenter trial is required to find therapies that would improve the prognosis.
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17
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Horiguchi H, Takada K, Kamihara Y, Ibata S, Iyama S, Sato T, Hayashi T, Miyanishi K, Sato Y, Takimoto R, Kobune M, Kobayashi K, Hirayama Y, Masumori N, Hasegawa T, Kato J. Radiation-induced leiomyosarcoma of the prostate after brachytherapy for prostatic adenocarcinoma. Case Rep Oncol 2014; 7:565-70. [PMID: 25232328 PMCID: PMC4164087 DOI: 10.1159/000366294] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Radiation therapy (RTx) has been employed as a curative therapy for prostatic adenocarcinoma. RTx-induced sarcomas (RISs) are rare, late adverse events, representing less than 0.2% of all irradiated patients. RISs are more aggressive tumors than prostatic adenocarcinomas. Herein, we present a case with RTx-induced prostatic leiomyosarcoma after permanent brachytherapy for prostatic adenocarcinoma. A 69-year-old male presented with dysuria and gross hematuria. Six years previously, he had been diagnosed with localized prostate cancer and was treated by permanent brachytherapy. Urethroscopy showed stenosis by a tumor at the prostate. Transurethral prostatectomy was performed for a diagnosis. Based on pathological findings, the diagnosis was leiomyosarcoma of the prostate. He was treated with three cycles of neoadjuvant chemotherapy (CTx) that consisted of doxorubicin and ifosfamide (AI), followed by a prostatocystectomy with intrapelvic lymphadenectomy. The tumor extended from the prostate and infiltrated the bladder wall and serosa with lymphatic and venous invasion. The surgical margin was negative, and no residual prostatic adenocarcinoma was observed. The proportion of necrotic tumor cells by neoadjuvant CTx was around 50%. Subsequently, adjuvant CTx was offered, but the patient chose a follow-up without CTx. Local recurrence and lung metastasis were detected by computed tomography 3 months after the surgery. He was treated again with AI. However, CTx was not effective and he died 6 months after the operation. In conclusion, an effective treatment strategy for prostatic sarcoma should be developed in the near future, although the clinical feature of prostatic sarcoma remains unclear due to its rare incidence.
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Affiliation(s)
- Hiroto Horiguchi
- Departments of Medical Oncology and Hematology, Sapporo, Japan ; Department of Internal Medicine, Higashi Sapporo Hospital, Sapporo, Japan
| | - Kohichi Takada
- Departments of Medical Oncology and Hematology, Sapporo, Japan
| | - Yusuke Kamihara
- Departments of Medical Oncology and Hematology, Sapporo, Japan
| | - Soushi Ibata
- Departments of Medical Oncology and Hematology, Sapporo, Japan
| | - Satoshi Iyama
- Departments of Medical Oncology and Hematology, Sapporo, Japan
| | - Tsutomu Sato
- Departments of Medical Oncology and Hematology, Sapporo, Japan
| | | | - Koji Miyanishi
- Departments of Medical Oncology and Hematology, Sapporo, Japan
| | - Yasushi Sato
- Departments of Medical Oncology and Hematology, Sapporo, Japan
| | - Rishu Takimoto
- Departments of Medical Oncology and Hematology, Sapporo, Japan
| | | | - Ko Kobayashi
- Departments of Urological Surgery and Andrology, Sapporo, Japan
| | - Yasuo Hirayama
- Department of Internal Medicine, Higashi Sapporo Hospital, Sapporo, Japan
| | - Naoya Masumori
- Departments of Urological Surgery and Andrology, Sapporo, Japan
| | - Tadashi Hasegawa
- Departments of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Junji Kato
- Departments of Medical Oncology and Hematology, Sapporo, Japan
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18
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Dong A, Bai Y, Wang Y, Zuo C, Lu J. Spectrum of the prostate lesions with increased FDG uptake on 18F-FDG PET/CT. ACTA ACUST UNITED AC 2014; 39:908-21. [DOI: 10.1007/s00261-014-0114-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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19
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Andreou A, Whitten C, MacVicar D, Fisher C, Sohaib A. Imaging appearance of sarcomas of the prostate. Cancer Imaging 2013; 13:228-37. [PMID: 23722584 PMCID: PMC3667567 DOI: 10.1102/1470-7330.2013.0024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Sarcomas of the prostate are rare tumours. Their clinicopathologic features are well described, however, the imaging features of these tumours have rarely been documented. The purpose of this article is to illustrate the imaging findings of prostate sarcomas, with an emphasis on their appearance on magnetic resonance imaging and to identify features that may help to differentiate them from the commoner prostate adenocarcinomas.
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Affiliation(s)
- Adrian Andreou
- Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk NR4 7UY, UK.
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20
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Wang X, Liu L, Tang H, Rao Z, Zhan W, Li X, Zeng H, Zhang P, Wei B, Lin T, Wei Q, Lu Y, Li X. Twenty-five cases of adult prostate sarcoma treated at a high-volume institution from 1989 to 2009. Urology 2013; 82:160-5. [PMID: 23601444 DOI: 10.1016/j.urology.2013.01.034] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 12/23/2012] [Accepted: 01/20/2013] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To analyze the clinical characteristics, treatment modalities, and outcomes of adult prostate sarcoma treated at our institution. MATERIALS AND METHODS The medical records of 25 adult patients with prostate sarcoma were obtained from January 1989 to December 2009. The clinicopathologic parameters were evaluated to determine their effect on survival. RESULTS The median age was 37 years (range 18-81). The median tumor size was 9.5 cm (range 4-25). The median serum prostate-specific antigen level was 1.39 ng/mL (range 0.39-33.20). The most common symptom was dysuria (72%). Transrectal ultrasound-guided needle biopsy was used to diagnose 22 sarcomas, transurethral resection of the prostate to diagnose 2, and open surgery to diagnose 1. The predominant histologic subtype was leiomyosarcoma (40%); 21 (88%) were high grade and 6 patients had metastatic disease. Surgical resection of curative intent was performed in 14 patients, with negative margins in 10. After a median follow-up of 21 months (range 5-63), 2 patients were disease free, 4 were alive with disease, and 19 had died of their disease. Overall, the 1-, 2-, 3-, and 5-year survival rate was 80.0%, 47.4%, 22.6%, and 11.3%, respectively, and the median survival time was 23 months. The median survival time after recurrence was 20 months (range 9-39) and that after metastasis was 10 months (range 3-23). Age >50 years, metastasis at presentation, and a lack of surgery with curative intent were independently predictive of an unfavorable outcome. CONCLUSION Adult prostate sarcoma accounted for 0.7% of primary prostate malignancies and carried a poor prognosis. Early diagnosis and surgical resection with curative intent offer patients the best chance of survival.
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Affiliation(s)
- Xianding Wang
- Department of Urology, Sichuan University, Chengdu, Sichuan, People's Republic of China
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21
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Barwad A, Khandelwal N, Vyas S, Gogoi D, Dey P. Primary leiomyosarcoma of the prostate with lung metastasis: report of a case diagnosed by fine-needle aspiration cytology. Diagn Cytopathol 2011; 39:700-2. [PMID: 21837659 DOI: 10.1002/dc.21539] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 08/05/2010] [Accepted: 08/05/2010] [Indexed: 11/10/2022]
Abstract
Prostate leiomyosarcoma is an extremely rare and highly aggressive neoplasm that accounts for less than 0.1% of primary prostate malignancies. Herein, we present a patient with primary leiomyosarcoma of the prostate with lung metastasis diagnosed primarily on fine-needle aspiration cytology. Characteristic cytological features such as small fascicles of spindle cells with blunt-ended nuclei, positivity for desmin and smooth muscle actin along with the radiological features are helpful in the correct diagnosis.
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