Primary Sarcoma of the Specialised Prostatic Stroma: A Case Report and Review of the Literature

Abstract

Primary sarcoma tumours of the prostate are rare and are classified, according to their histology, as stromal tumours of uncertain malignant potential (STUMP) and stromal prostatic sarcoma (PS; low and high grade). We describe a case of a 71-year-old man that developed progressive urinary obstruction symptoms and was subjected to a transurethral prostatic resection (TURP). Histologically, there is a diffuse proliferation of epithelioid and spindle cells that showed rare atypical mitotic figures. Immunohistochemically, the neoplastic cells express diffusely CD34 and focally progesterone whereas no immunoreactivity was seen for cytocheratin, desmin, S-100, Bcl-2, chromogranin, CD117, and actin smooth muscle. A final diagnosis of low-grade prostatic stromal sarcoma (LG-PS) was made. This is a really rare neoplasm; in the literature, in fact, to our knowledge, only 6 cases are described and all of these were alive and free of disease at followup. Our patient too is free of disease at 15 months from the diagnosis.

Primary spindle cell sarcoma of the prostate and 18 F-fluorodeoxyglucose-positron-emission tomography/computed tomography findings

“…In contrast to BPH, STUMP can recur frequently and occur at younger men. [ 12 ] Sometimes high- and low-grade prostatic stromal sarcoma was associated with STUMP. Herawi and Epstein, in fact, found that seven (14%) of the 50 stromal tumors of the prostate that they analyzed were STUMPs associated with sarcoma (four high-grade stromal sarcoma, three LG-PS).…”

Is it really an abscess? An unusual case of metastatic stromal cell sarcoma of the prostate

“…Prostatic stromal sarcomas account for about 0.1% of all prostatic malignancies [3] , [4] . They usually present symptomatically as haematuria, haematospermia, urinary retention and as a palpable rectal mass [2] , [3] , [5] , [6] . A wide age distribution from 26 to 85 years has been reported [3] .…”

“…Microscopically, PSS display a growth of spindle cells in the stroma of the prostate; either alone or mixed in with benign glandular tissue [5] . These neoplastic spindle cells show cytological atypia, mitotic figures, and necrosis [2] , [5] , [6] . The solid component of the tumour can show various patterns of cell arrangement such as storiform, epithelioid, fibrosarcomatous, or patternless patterns [5] , [6] .…”

“…These neoplastic spindle cells show cytological atypia, mitotic figures, and necrosis [2] , [5] , [6] . The solid component of the tumour can show various patterns of cell arrangement such as storiform, epithelioid, fibrosarcomatous, or patternless patterns [5] , [6] . Depending on the amount of histological features that are present these tumors can be further classified into high or low grade malignancies [2] , [6] .…”

Primary prostate sarcoma: how to manage following diagnosis at transurethral resection

“…Primary prostate sarcomas are rare, with one study estimating it to comprise of just 0.7% of prostatic malignancies [ 1 ]. It typically arises from specialized hormone-dependant mesenchymal cells of the prostatic stroma [ 2 ]. A diverse histological pattern has been described in the literature, often closely related to stromal tumours of uncertain malignant potential (STUMP).…”