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An ambivalent prostate nodule after Bacillus Calmette-Guérin therapy.
L Sauvat1, Q Lhermite2, C Desplechain3
1Infectious and Tropical Disease Unit, CHU Clermont-Ferrand, 58 Rue Montalembert, France.
Bacillus Calmette-Guérin (BCG) therapy can rarely cause prostate issues mimicking cancer. Early testing for Mycobacterium bovis in prostate samples is crucial to avoid unnecessary surgery.
Area of Science:
- Urology
- Infectious Diseases
- Oncology
Background:
- A 65-year-old patient underwent treatment for high-grade non-invasive papillary urothelial carcinoma.
- Treatment involved surgery and intravesical Bacillus Calmette-Guérin (BCG) instillations.
Observation:
- Follow-up MRI revealed a prostate nodule suspicious for capsular invasion.
- Prostatic biopsies showed granulomatous inflammation and a focus of adenocarcinoma.
- Urinary tests confirmed Mycobacterium bovis infection.
Findings:
- The prostate nodule was a rare prostatic abscess caused by Mycobacterium bovis, mimicking prostate cancer on MRI.
- The patient successfully completed a 9-month course of anti-mycobacterial therapy.
Implications:
- This case highlights the importance of considering BCG-induced mycobacterial infection in patients with suspicious prostate findings.
- Recommends specific prostate and urine sample testing for mycobacteria to prevent misdiagnosis and aggressive surgical intervention.
- Emphasizes the need for careful diagnostic workup to differentiate infectious granulomatous disease from malignancy.
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