Nonepithelial Tumors and Tumor-Like Lesions of the Prostate Gland

Abstract

Many significant benign and malignant nonepithelial tumors and stromal tumor-like lesions arise in the prostate gland. Although such lesions are rare, their recognition by the pathologist is essential because their treatment and prognosis are quite variable. In this review, lesions of the specialized prostatic stroma, that is, lesions that can be seen in the stroma of the prostate but not in that of other organs, except for the phyllodes type of lesions, are discussed. Benign and malignant lesions of the soft tissues that occur in the stroma of other organs and are seen with some frequency in the prostate are also discussed. Few of the rarer soft tissue lesions are mentioned. Lesions and tumors with melanocytic differentiation, hematopoietic derivation, and germ cell tumors are described. It is hoped that this review will serve as a useful reference when encountering some of these lesions, all of which are referenced to their original and subsequent reports. Some non-English language references are also cited to reflect the international recognition of these lesions or to give credit to the author who first described the entity.

Hemangioma of the prostate - an unusual cause of lower urinary tract symptoms: Case report

“…Routine rectal ultrasound used to measure prostatic volume did not reveal the presence of a hemangioma in our patient. A definitive preopertative diagnosis can usually be achieved through arteriography of the internal iliac arteries [6]. Treatment of hemangioma in the bladder and prostate has varied from electrocautery, Nd-YAG laser to radiation or in cases of periprostatic hemangioma with selective arterial embolization [5,7,8].…”

Non‐epithelial neoplasms of the prostate

“…specialized stromal tumours) and similar tumours occurring in extraprostatic sites [e.g. smooth muscle tumour, myofibroblastic tumour, solitary fibrous tumour (SFT), and gastrointestinal tumour (GIST)] 1–3 . However, there is only a limited body of literature to clearly define the clinical and pathological features of these entities, and some aspects are still evolving or are controversial, requiring further studies.…”

A Prostate Fibromyxoid Sarcoma With Smooth Muscle Differentiation in a F344xBNF1 Rat

“…These patterns differ as to whether glands of nonmalignant prostate epithelial cells are present within the lesion (patterns I, II, and III), what appearance the glands have (normal in patterns I and II compared with compressed and proliferative in pattern III), and whether the proliferative stromal cells exhibit any cytologic atypia (patterns I and III). 2,5,7,15 With its expansile growth, lack of glandular elements, and absence of mitotic figures, the lesion within the prostate of the rat is most similar to PSPUMP pattern IV. However, cytologic atypia is reportedly absent in PSUMP pattern IV, whereas we describe mild cytologic atypia in the rat prostate lesion.…”

“…16 While men with prostate cancer most frequently have adenocarcinomas, various sarcomas of the prostate have also been described, as well as nonmalignant stromal proliferations and prostatic stromal proliferations of uncertain malignant potential (PSPUMPs) . 2,[4][5][6][7][8][11][12][13]15,17 To our knowledge, the only prostatic neoplasms that have been described in rats are adenocarcinomas; no stromal tumors or stromal hyperplasia have been described to date. Therefore, the case presented herein is the first case of a prostate sarcoma in a rat.…”

“…PSPUMPs are rare proliferations of the prostatic stroma in men. 2,5,7,15 These stromal proliferations are described as having uncertain malignant potential because they may recur after surgical excision and may progress to sarcomas. 2,5,7 Further information regarding the malignant potential of these lesions is lacking because of their rarity and the dearth of long-term case follow-up.…”