Xanthogranulomatous Prostatitis: Novel Presentation of a Rare Condition

Area of Science:

• Urology
• Pathology

Background:

• Xanthogranulomatous prostatitis is an exceptionally rare condition, with fewer than 15 cases documented globally.
• Typical presentations involve lower urinary tract symptoms or infections.

Observation:

• A 65-year-old male presented with a year-long history of pelvic floor disorder, including tenesmus and perineal pain, followed by urinary retention.
• Prostate MRI revealed a PI-RADS 5 lesion in the left peripheral zone with suspicious lymphadenopathy; prostate-specific antigen was normal.
• Prostatic biopsy confirmed acute and chronic inflammation with xanthogranulomatous features, excluding necrosis.

Findings:

• The patient experienced symptom remission, including pain resolution, after a 6-week course of ciprofloxacin and low-dose Cymbalta.
• Treatment was effective without alpha-blockers, corticosteroids, or pelvic floor therapy.

Implications:

• This case underscores the possibility of atypical presentations of xanthogranulomatous prostatitis, initially manifesting as pelvic floor disorders.
• Highlights a potential therapeutic regimen for this rare prostatitis variant.