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Updated: May 30, 2026

A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
MRI appearance of prostatic stromal sarcoma in a young adult
Tsutomu Tamada1, Teruki Sone, Yoshiyuki Miyaji
1Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, Japan. ttamada@med.kawasaki-m.ac.jp
Abstract:
Prostatic stromal sarcoma (PSS) is quite rare. Herein, we describe magnetic resonance imaging (MRI) features of a PSS identified in a 26-year-old man with dysuria and hematuria. MRI clearly depicted the extent and multinodular appearance of the tumor, which was mainly located in the central zone of the prostate. The tumor appeared as a heterogeneously signal-hyperintense mass with a pseudocapsule on T2-weighted imaging. Contrast-enhanced T1-weighted MRI showed necrotic portions in the gradually enhanced solid mass, and diffusion-weighted imaging permitted the accurate assessment of the local extent of the tumor. Thus, the appearance on MRI was quite different from that of adenocarcinoma of the prostate.
Insights
Prostatic stromal sarcoma (PSS) is a rare tumor. This case highlights its distinct MRI features, differentiating it from common prostate cancers.
Area of Science:
- Radiology
- Oncology
- Uropathology
Background:
- Prostatic stromal sarcoma (PSS) is an exceptionally rare malignant tumor originating from the prostate's connective tissues.
- Distinguishing PSS from more common prostate malignancies like adenocarcinoma is crucial for appropriate management.
Observation:
- This report details the magnetic resonance imaging (MRI) findings in a 26-year-old male patient presenting with dysuria and hematuria.
- The MRI revealed a multinodular tumor predominantly in the prostate's central zone, characterized by a heterogeneous signal intensity and a pseudocapsule on T2-weighted images.
Findings:
- Contrast-enhanced T1-weighted MRI demonstrated a solid mass with areas of necrosis and gradual enhancement.
- Diffusion-weighted imaging provided precise evaluation of the tumor's local extent.
- The overall MRI appearance was markedly different from typical prostatic adenocarcinoma.
Implications:
- Accurate radiological characterization of PSS is vital for diagnosis and treatment planning.
- MRI's multi-sequence capabilities aid in differentiating rare prostatic tumors.
- This case contributes to the understanding of PSS imaging characteristics, aiding clinicians in recognizing this uncommon entity.
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