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ObjectiveThe objective of this study is to evaluate the clinical presentations, diagnostic approaches, and treatment modalities for primary prostate sarcoma postradical prostatectomy, aiming to enhance its diagnosis and management.MethodsWe retrospectively reviewed the clinical records of three male patients diagnosed with primary prostate sarcoma at Beijing Chaoyang Hospital, affiliated with Capital Medical University, from February 2014 to February 2024. All patients underwent transrectal prostate biopsies, which informed the decision to proceed with laparoscopic radical prostatectomies. After surgery, one patient received a combination of epirubicin and ifosfamide as immunotherapy, along with external beam radiotherapy. After comprehensive discussions regarding potential benefits and risks, the remaining two patients decided against undergoing radiotherapy and chemotherapy.ResultsBased on the pathological examination results, two patients were diagnosed with stromal sarcoma and one with spindle cell sarcoma, all classified as high‐grade sarcomas. Immunohistochemical analysis showed that all three cases were positive for VIMENTIN, but other results did not show significant specificity. During the follow‐up period, one patient died within 12 months, and two patients were lost to follow‐up after 6 months. However, there were no evident signs of recurrence observed during the follow‐up period.ConclusionsPrimary prostate sarcoma is extremely rare and typically has a poor prognosis once diagnosed. Early diagnosis should be based on pathological and immunohistochemical testing results, followed by prompt surgical treatment and adjuvant radiotherapy and chemotherapy. Despite these measures, recurrence is common, underscoring the need for a detailed and appropriate treatment plan and systematic therapy for affected patients.
ObjectiveThe objective of this study is to evaluate the clinical presentations, diagnostic approaches, and treatment modalities for primary prostate sarcoma postradical prostatectomy, aiming to enhance its diagnosis and management.MethodsWe retrospectively reviewed the clinical records of three male patients diagnosed with primary prostate sarcoma at Beijing Chaoyang Hospital, affiliated with Capital Medical University, from February 2014 to February 2024. All patients underwent transrectal prostate biopsies, which informed the decision to proceed with laparoscopic radical prostatectomies. After surgery, one patient received a combination of epirubicin and ifosfamide as immunotherapy, along with external beam radiotherapy. After comprehensive discussions regarding potential benefits and risks, the remaining two patients decided against undergoing radiotherapy and chemotherapy.ResultsBased on the pathological examination results, two patients were diagnosed with stromal sarcoma and one with spindle cell sarcoma, all classified as high‐grade sarcomas. Immunohistochemical analysis showed that all three cases were positive for VIMENTIN, but other results did not show significant specificity. During the follow‐up period, one patient died within 12 months, and two patients were lost to follow‐up after 6 months. However, there were no evident signs of recurrence observed during the follow‐up period.ConclusionsPrimary prostate sarcoma is extremely rare and typically has a poor prognosis once diagnosed. Early diagnosis should be based on pathological and immunohistochemical testing results, followed by prompt surgical treatment and adjuvant radiotherapy and chemotherapy. Despite these measures, recurrence is common, underscoring the need for a detailed and appropriate treatment plan and systematic therapy for affected patients.
Undifferentiated pleomorphic prostate sarcoma is an extremely rare neoplasm. In the available literature, less than 50 clinical cases were described. Usually, the clinical manifestation of the disease is nonspecific and is primarily associated with bladder outlet obstruction. Additionally, most patients have normal levels of prostate-specific antigen, while ultrasound and MRI can visualize irregularly shaped lesions, often extending beyond the prostate gland. Diagnosis requires exclusion of other signs of specific differentiation, apart from fibroblastic and myofibroblastic. There is no established treatment plan for patients with pleomorphic prostate sarcoma due to extreme rarity of the disease. For localized forms of the disease, radical laparoscopic prostatectomy is often used, but more aggressive treatment options are also being considered, including total pelvic exenteration, chemotherapy and radiation therapy. However, in most cases metastasis is revealed after primary treatment. Regional metastases are often localized in the rectum, bladder, in the area of previous surgery, and regional lymph nodes, while distant metastases are found in the lungs, liver, bones and distant lymph nodes, thereby indicating aggressive progression and poor prognosis of the disease.In this article, we present our own clinical observation of a patient with confirmed undifferentiated pleomorphic prostate sarcoma.
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