When pathology defies expectations: a surprising diagnosis of prostatic leiomyosarcoma

Authors

  • Abhijit Shah Department of Urology and Renal Transplant, Kasturba Medical College, Manipal, Karnataka, India https://orcid.org/0000-0002-8660-8580
  • Anshuman Singh Department of Urology and Renal Transplant, Kasturba Medical College, Manipal, Karnataka, India https://orcid.org/0000-0002-3289-6484
  • Kasi V. Gali Department of Urology and Renal Transplant, Kasturba Medical College, Manipal, Karnataka, India https://orcid.org/0000-0002-8212-5303
  • Vijay Gunashekaran Department of Urology and Renal Transplant, Kasturba Medical College, Manipal, Karnataka, India
  • Padmaraj Hegde Department of Urology and Renal Transplant, Kasturba Medical College, Manipal, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20234020

Keywords:

Prostatic neoplasm, Sarcoma, Leomyosarcoma, Lower urinary tract symptoms

Abstract

Prostatic leiomyosarcoma is an exceedingly rare malignant tumour arising from smooth muscle cells in the prostate gland. It ranks quite low down on the possible differentials of bladder outlet obstruction. We present a case of a 38-year-old male who initially presented with acute urinary retention and was subsequently diagnosed with prostatic leiomyosarcoma. Following histopathological confirmation, metastatic work-up was performed and patient planned for radiation and surgical cure. Patient on follow-up is well and has resumed normal daily work. This case report aims to increase awareness of this rare malignancy, discuss the diagnostic challenges faced with a highly common clinical spectrum at the onset, present the treatment strategies employed, and discuss the patient's clinical outcomes. We emphasise the importance of reporting rare cases like this to contribute to the existing literature and enhance the understanding of prostatic leiomyosarcoma.

References

Cheville JC, Dundore PA, Nascimento AG, Meneses M, Kleer E, Farrow G, et al. Leiomyosarcoma of the Prostate Report of 23 Cases. Cancer. 1995;76(8):1422-7.

Zazzara M, Divenuto L, Scarcia M, Cardo G, Maselli FP, Ludovico GM. Leiomyosarcoma of prostate: Case report and literature review. Urol Case Rep. 2018;17:4.

Venyo AKG. A Review of the Literature on Primary Leiomyosarcoma of the Prostate Gland. Adv Urol. 2015;485786.

Tawfic S, Niehans GA, Manivel JC. The pattern of CD10 expression in selected pathologic entities of the prostate gland. Hum Pathol. 2003;34(5):450-6.

Pathology Outlines. Postoperative spindle cell nodule. 2014. Available at: https://www.pathology outlines.com/topic/bladderpostopspindle.html. Accessed on 12 September 2023.

Wick MR, Young RH, Malvesta R, Beebe DS, Hansen JJ, Dehner LP. Prostatic carcinosarcomas. Clinical, histologic, and immunohistochemical data on two cases, with a review of the literature. Am J Clin Pathol. 1989;92(2):131-9.

Yamazaki H, Ohyama T, Tsuboi T, Taoka Y, Kohguchi D, Iguchi H, et al. Prostatic stromal sarcoma with neuroectodermal differentiation. Diagn Pathol. 2012;7(1):173.

Hossain D, Meiers I, Qian J, MacLennan GT, Bostwick DG. Prostatic leiomyoma with atypia: follow-up study of 10 cases. Ann Diagn Pathol. 2008;12(5):328-32.

Hansel DE, Herawi M, Montgomery E, Epstein JI. Spindle cell lesions of the adult prostate. Modern Pathol. 2006;20(1):148-58.

Xu ZN, Cai T, Zhou ZB, Wu JT, Gao ZL. Prostate leiomyosarcoma treatment using three-dimensional reconstruction: a case report and literature review. J Mens Health. 2021;17(2):148-53.

Vandoros GP, Manolidis T, Karamouzis MV, Gkermpesi M, Lambropoulou M, Papatsoris AG, et al. Leiomyosarcoma of the prostate: case report and review of 54 previously published cases. Sarcoma. 2008;458709.

Poonia DDR, Singh DA, Sunil H, Gandhi DJ, Rawal DS. Management of Leiomyosarcoma of the Prostate: Unraveling a Hoax. Curr Prob Cancer. 2021;3:100068.

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Published

2023-12-28

How to Cite

Shah, A., Singh, A., Gali, K. V., Gunashekaran, V., & Hegde, P. (2023). When pathology defies expectations: a surprising diagnosis of prostatic leiomyosarcoma. International Journal of Research in Medical Sciences, 12(1), 280–283. https://doi.org/10.18203/2320-6012.ijrms20234020

Issue

Section

Case Reports