Pure Primary Prostatic Osteosarcoma Arising in a Non-Irradiated Prostate

Rabbani, Farhang; Fine, Ronnie; D’Adamo, David R.; Edgar, Mark A.; Akın, Oğuz; Paty, Philip B.

doi:10.1159/000230031

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…A second search, with the same limiters, was conducted using the search terms “prostate” and “sarcomatoid carcinoma”. Twenty-seven papers were retrieved, only three of which involved ≥5 patients 10 , 11 , 35…”

Section: Discussionmentioning

confidence: 99%

Spindle-cell carcinoma of the prostate

Silva¹,

Claros²,

Amselem³

et al. 2012

ACR

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Sarcoma of the prostate and sarcomatoid carcinoma of the prostate are rare conditions, both characterized by a poor prognosis. Sarcomatoid carcinoma of the prostate typically arises from the evolution of an underlying adenocarcinoma, occasionally featuring heterologous elements, bulky disease being possible but rare. In contrast, sarcoma of the prostate derives from non-epithelial mesenchymal components of the prostatic stroma, shows rapid growth, and frequently presents as massive pelvic tumors obstructing the urinary tract at the time of diagnosis. We report the case of a 55-year-old patient with a two-month history of symptoms of urinary obstruction. The patient presented with an extremely enlarged heterogeneous prostate, although his prostatespecific antigen level was low. The lack of a history of prostatic neoplasia led us to suspect sarcoma, and a transrectal prostate biopsy was carried out. An immunohistochemical study of the biopsy specimen did not confirm the clinical suspicion. However, in view of the clinical features, we believe that sarcoma of the prostate was the most likely diagnosis. The patient received neoadjuvant chemotherapy followed by radiation therapy. At this writing, surgical resection had yet to be scheduled.Keywords: Prostate; Sarcoma; Carcinoma. CASE REPORTWe report a case of a 55-year-old male patient who sought treatment in the Surgery Department Hospital. His primary complaint was acute urinary retention. He had a two-month history of symptoms of urinary obstruction. Physical examination revealed hard, lobulated enlargement of the prostate. Computed tomography (CT) scans of the abdomen and pelvis (Figures 1 and 2) showed an extremely enlarged heterogeneous prostate (estimated volume, 300 cc) without evidence of adjacent tissue invasion. At diagnosis, his serum prostatespecific antigen (PSA) level was 0.7 ng.mL -1 (reference range, 0-4 ng.mL -1 ). Despite urinary catheterization, the patient developed renal failure. Another CT scan performed on postadmission day 10 showed rapid tumor growth, the volume of the prostate having increased to 700 cc.

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Section: Discussionmentioning

confidence: 99%

Spindle-cell carcinoma of the prostate

Silva¹,

Claros²,

Amselem³

et al. 2012

ACR

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“…Rabbani et al. 160 described an aggressive and lethal prostate tumour in a 68‐year‐old composed of undifferentiated pleomorphic spindle cells with osteoid formation and osteoclastic giant cells. Nishiyama et al.…”

Section: Miscellaneous Mesenchymal Tumours Of the Prostatementioning

confidence: 99%

“…However, there are sporadic reports of bone or cartilage forming tumours involving the prostate that were not carcinoma-associated. Rabbani et al 160 described an aggressive and lethal prostate tumour in a 68-year-old composed of undifferentiated pleomorphic spindle cells with osteoid formation and osteoclastic giant cells. Nishiyama et al 161 also reported an aggressive and lethal prostate tumour composed of pleomorphic cells with osteoid formation.…”

Section: Osteogenic and Chondrogenic Tumoursmentioning

confidence: 99%

Non‐epithelial neoplasms of the prostate

et al. 2011

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Non-epithelial prostatic neoplasms are infrequent and cover a broad array of entities that include both benign and highly aggressive tumours. Because they are very infrequent, there is often limited understanding of them, and the recognition of these entities, when encountered, may pose a diagnostic challenge, owing to histological overlap between them or their rarity. Most lesions in this category are mesenchymal in origin, such as prostatic stromal tumours arising from specialized prostatic stroma, smooth muscle tumours, both benign and malignant, and solitary fibrous tumours. Less commonly occurring tumours include neural, germ cell and melanocytic tumours that may be derived from cells not normally present in the prostate. Some tumours have well-established extraprostatic counterparts and, when encountered, are more commonly extraprostatic/secondary in origin; these include gastrointestinal stromal tumours and most haematopoietic tumours. The majority of tumours are characterized by a spindle cell pattern with significant overlap in morphological features. In this setting, appropriate use of immunohistochemistry and molecular studies are often necessary for accurate diagnosis, prognosis, or prediction for therapy. This review addresses and updates the clinicopathological features of the entire spectrum of non-epithelial tumours with an approach to the histological diagnosis.

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