Ziarniniakowe zapalenie stercza po immunoterapii dopęcherzowej imitujące raka stercza

Abstract

Intravesical immunotherapy with attenuated strains of Mycobacterium bovis is a widely used therapeutic option in patients with non-muscle-invasive transitional cell carcinoma of the bladder. A rare complication of intravesical therapy with the Bacillus Calmette-Guérin vaccine is granulomatous prostatitis, which due to increasing levels of prostate-specific antigen and abnormalities found in transrectal examination of the prostate may suggest concomitant prostate cancer. A case of extensive granulomatous prostatitis in a 61-year-old patient which occurred after the first course of a well-tolerated Bacillus Calmette-Guérin therapy is presented. Due to abnormalities found in rectal examination and an abnormal transrectal ultrasound image of the prostate with extensive infiltration mimicking neoplastic hyperplasia a core biopsy of the prostate was performed. Histopathological examination revealed inflammatory infiltration sites of tuberculosis origin.

Granulomatous prostatitis after bacille Calmette-Guérin instillation resembles prostate carcinoma: A case report and review of the literature

“…MP-MRI is widely used in the diagnosis of prostate cancer because it has good sensitivity for the localization and detection of over International Society of Urological Pathology grade 2 carcinomas[ 36 - 38 ]. With the inability to differentiate between granulomatous prostatitis and prostate cancer on transrectal ultrasound[ 25 ], specific characteristics of BCG-induced granulomatous prostatitis on MP-MRI have been proposed recently. In the case patient, an abnormal focus showed low signal in T2-weighted images and an apparent diffusion coefficient in the peripheral zone, which has been reported previously[ 24 , 26 , 27 , 31 , 39 ].…”

“…Most BCG-induced granulomatous prostatitis is asymptomatic and does not require treatment[ 26 , 31 ]. The 4-quinolones and antituberculotics including isoniazid, rifapentine, pyrazinamide, and ethambutol are used in symptomatic BCG-induced granulomatous prostatitis and some BCG-induced prostatic abscesses[ 25 , 30 , 52 - 54 ]. If anti-tuberculosis treatment is ineffective, surgery such as transurethral resection of prostate is recommended[ 55 ].…”