Images - Solitary fibrous tumor of the prostate

[Laparoscopic radical resection of large (223 g) solitary fibrous tumor of the prostate: a case report]

A 67-year-old male patient was referred to our hospital by the community health service center for "sudden dysuria for half a day". The diagnosis of solitary fibrous tumor of the prostate was established after transrectal prostate biopsy. After excluding contraindications, laparoscopic radical prostatectomy with bladder neck urethrostomy was performed. The operation was completed in 3 h and 15 min with an intraoperative blood loss of about 100 mL. Postoperative examination of the resected tumor revealed a large spherical tumor mass measuring about 11 cm×7.5 cm×6 cm with a net weight of 223 g. Postoperative pathology suggested solitary fibrous tumor of the prostate (medium-risk type). The abdominal drainage tube was removed 5 days after the operation and the catheter was removed 1 week after operation. The patient had good urine control at night without incontinence but with occasional urine leakage during daytime, and the overall therapeutic effect was satisfactory. Postoperative follow-up found good urine control of the patient without signs of tumor recurrence or metastasis. Laparoscopic radical prostatectomy often is difficult for large prostate tumors with a weight exceeding 200 g, and requires the surgeon to have rich experience in laparoscopic surgery with good understanding of prostate anatomy and close cooperation of the operation team to achieve satisfactory oncology control and functional protection of the urinary system.

Solitary fibrous tumors in prostate: a case report with review of the literature

BACKGROUND

Solitary fibrous tumor (SFT) is a relatively rare type of mesenchymal neoplasm that occurs most frequently in the pleura. However, SFT originating from the prostate is particularly uncommon and only approximately 39 cases were reported before. Herein, we reported a rare case of a patient diagnosed with prostate SFT and presented a literature review.Case presentation: A 50-year-old Asian with irritative urinary symptoms was admitted to our hospital and almost all the evidence indicated that benign prostate hyperplasia (BPH) caused his symptoms. Therefore, transurethral resection of the prostate (TURP) was performed, but histopathological and Immunohistochemical (IHC) assessments showed that spindle cells arranged disorderly in the TURP specimen with a cluster of differentiation 34 (CD34), B-cell lymphoma-2 (Bcl-2), and signal transducer and activator of transcription 6 (STAT6) highly expressed and SFT was diagnosed. Finally, the patient underwent a radical prostatectomy and there was no disease progression observed thereafter.

CONCLUSIONS

Prostate SFT is extremely rare, and to our knowledge, this is the first case of prostate SFT that is difficult to differentiate from small volume BPH. IHC examinations are of great diagnostic value. Radical resection of the tumor appears to be the most effective method at present and continuous follow-up is highly recommended.

Solitary Fibrous Tumor of the Prostate: A Case Report and Literature Review

Solitary fibrous tumors (SFTs) usually occur in the pleura and account for two-thirds of all cases; however, SFTs occurring in the prostate are extremely rare. Approximately 25 cases have been reported in the literature to date. This study reports the case of a 43-year-old man referred to our hospital with the chief complaint of a pelvic tumor after careful examination. The tumor marker levels were within normal limits. T2-weighted magnetic resonance imaging revealed a tumor, demonstrating primarily low signal intensity. It showed a capsule-like rim at the left lobe of the prostate, suggesting that the tumor was partially invading the rectal wall. Histopathological examination of needle-core biopsies showed spindle cell neoplasm with small and fusiform cells, strongly expressing signal transducer and activator of transcription 6 (STAT6) with a ramifying vascular network. Therefore, the clinical diagnosis of the patient was SFT of the prostate and robot-assisted radical prostatectomy was performed. Histopathological examination revealed that the tumor was composed of spindle cells with patternless and staghorn patterns. Immunohistochemical analysis showed a strong expression of STAT6. Furthermore, the tumor was partially positive for CD34. Therefore, the patient was diagnosed with SFT of the prostate. Two years after the initial diagnosis, the patient was alive with normal erectile function, continence status, and no evidence of the disease.