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Published on: May 19, 2022
A Prostatic Extra-Gastrointestinal Stromal Tumor Treated by Surgery: A Case Report with 7-Year Follow-Up and Review
Enguang Yang1, Suoshi Jing1, Guangrui Fan1
1Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Urological Diseases, Gansu Province (Lanzhou University), Gansu Nephro-Urological Clinical Center, 730031 Lanzhou, Gansu, China.
Background:
Prostatic extra-gastrointestinal stromal tumors (EGISTs) are notably uncommon, and the effectiveness of radical prostatectomy in managing these tumors has not been definitively established.
Case Summary:
A male patient, aged 71, with a history of two previous bowel resections, reported to the Department of Urology exhibiting symptoms of frequent urination, urgency, and difficulty in defecation persisting for three years. A digital rectal examination indicated the prostate was considerably enlarged, smooth, and firm. The concentrations of total serum total prostate-specific antigen (PSA) and free PSA were recorded at 0.15 ng/mL and 0.04 ng/mL, respectively. A transrectal ultrasound (TRUS) revealed a hypoechoic mass within the prostate, measuring 14.1 × 11.9 × 11.1 cm. Subsequent magnetic resonance imaging (MRI) showed a large, distinct lesion characterized by aggressive growth that compressed the adjacent rectum and bladder, initially suggesting a prostate sarcoma originating from the interlobular tissues. Guided by TRUS, a prostate biopsy indicated the presence of either a benign mesenchymal tumor or a solitary fibrous tumor (SFT). The patient was treated with radical prostatectomy, cystectomy, urinary diversion, and colostomy, leading to the final diagnosis of an EGIST. Throughout a follow-up of seven years, there was no sign of tumor recurrence.
Conclusion:
Prostatic EGISTs, while exceedingly rare, require differentiation from other neoplasms such as sarcomas and SFTs. Radical prostatectomy has demonstrated efficacy as a treatment option for these resectable tumors.
