Painless Gross Hematuria: A New Presentation of Primitive Neuroectodermal Tumor of the Prostate

Abstract

Introduction: Primitive neuroectodermal tumor (PNET) is a very rare type of prostate sarcoma that mostly occurs in young adults, and it is associated with a poor prognosis. Case Presentation: A 37-year-old male was admitted with intermittent painless gross hematuria from 1 month prior to admission. Cystosocopy, abdominopelvic computed tomography scan (ACTS), and magnetic resonance imaging (MRI) revealed huge prostate. All tumor markers were negative and pathology findings of trans-rectal ultrasonographic biopsy (TRUS Bx) and trans-urethral resection of prostate (TURP) were consistent with severely inflamed prostatic urethra with no evidence of malignancy. The patient underwent radical prostatectomy. Histopathology of the specimens showed malignant neoplasm of small round and oval cells suggestive of PNET. Immunohistochemistry (IHC) study results on CD99 were positive. Conclusions: We report a rare uncommon case of prostate PNET presented by intermittent painless gross hematuria. As the prognosis is very poor, medical staff should pay enough attention to the differential diagnosis, choosing the best treatment and subjects close follow-up.

Kasa Bedah Yang Tertinggal Setelah 1 tahun Tindakan Operasi: Studi Kasus Prosedur Pemeriksaan MRI Whole Abdomen Gossypiboma

“…Gossypiboma paling sering ditemukan di perut (56%), panggul (18%), dan thorax (11%) 3 . Prosedur, yang dilaporkan dalam beberapa laporan kasus, rata-rata sekitar 1/1000-1500 prosedur 5 . Gossypiboma dapat tetap diam atau menyebabkan reaksi peradangan.…”

“…Lesi hiperintens inhomogen pada T2FSE (T2-Weighted Fast Spin Echo) disuprapubic ditunjukkan dengan tanda panah Menurut penelitian babak 2017, kejadian gossypiboma dapat terjadi karena beberapa factor resiko diantaranya Perubahan staf ruang operasi, operasi darurat, perubahan prosedur yang tidak terduga, jumlah staf yang tidak memadai, durasi operasi yang lama, hitungan spons yang terburuburu, staf yang tidak berpengalaman, kondisi pasien yang tidak stabil, pasien obesitas, kehilangan darah yang berlebihan pada pasien trauma, dan kegagalan untuk menghitung instrumen bedah dan spons. Tiga faktor risiko terpenting adalah operasi darurat, perubahan operasi yang tidak direncanakan, dan indeks massa tubuh 5,9,10 .…”