A case of prostate stromal sarcoma involving the rectum

Abstract

Sarcomas and related proliferative lesions of the specialized stroma of the prostate are very rare and have been classified into prostate stromal sarcoma (PSS) and prostatic stromal tumor of uncertain malignant potential based on histology. We herein describe a case of PSS. A 40-year-old male presented at a hospital with urinary distention. Magnetic resonance imaging revealed a large prostate mass, and the diagnosis was prostate sarcoma of uncertain differentiation by ultrasound-guided needle biopsy. Total pelvic exenteration was performed and a pathological diagnosis of PSS was ultimately reached. Ten months later, there have been no signs of metastasis or recurrence.

A case of complete resection of prostate stromal sarcoma after neoadjuvant chemotherapy

“…2 The most common metastatic site is the lung. 1 There are no specific imaging findings for PSS; however, in the present case, MRI detected rectal invasion. PSS may not increase PSA levels, which were normal in the present case.…”

“…2 PSS is generally vimentin, CD34, and PgR positive, and negative for ER, but CD34 and PgR were negative in this case. 1,2 Most cases show an increased Ki-67 labeling index, with the present case showing an 80% increase. 1 The treatment of PSS is mainly surgical resection, with extended resection selected according to the degree of tumor growth.…”

“…1 The treatment of PSS is mainly surgical resection, with extended resection selected according to the degree of tumor growth. 1 Complete excision is recommended because PSS may rapidly develop LR or distant metastasis after incomplete excision. 5 This case achieved long-term survival with an extended resection for tumor control.…”

“…The main histological types of prostate sarcoma in adults are leiomyosarcoma and rhabdomyosarcoma, whereas PSS is a rarer histological type. Approximately 30 cases of PSS have been reported 1,2 . PSS was reported previously using various names, such as phyllodes tumor; however, in 1998, cases of PSS where considered either prostatic stromal PSPUMP or PSS according to the degree of cellularity, mitotic figures, necrosis, and stromal overgrowth for the purpose of understanding biological prognosis and guiding treatment 3 .…”

“…In 1998, PSS was classified into 2 types: PSS and STUMP. Surgical resection is the treatment of choice, as the effectiveness of NAC is unknown 1 . Here, we report a case of PSS, in which the tumor was completely resected after NAC with GEM and DTX.…”