Spindle-cell carcinoma of the prostate

Abstract

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.

The first three years of Autopsy and Case Reports: an interesting journey

“… 2 , 10 - 18 Finally, in a total of 675 full-text downloads, 2 of the top 10 downloaded articles were autopsy reports ( Table 4 ). 4 , 6 , 19 - 26…”

In the pursuit of indexing

“…Many case reports published in Autopsy and Case Reports to date are accompanied by a literature review, providing the reader with an update on the issue at hand. Examples include the articles “Hemophagocytic lymphohistiocytosis of indeterminate cause: a fatal adult case,”6 and “Spindle-cell carcinoma of the prostate.”7 Although they do not have the obvious subtitle “case report and review of the literature,” they are, in fact, practical review articles, and could be classified as original articles according to current criteria. From the standpoint of an editor, here is the dilemma: should a systematic review in a case report be mandatory?…”