Aggressive Prostatic Stromal Sarcoma Mimicking Benign Prostatic Enlargement in a Middle-Aged Man: A Case Report.

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• Prostatic stromal sarcoma is an exceptionally rare mesenchymal malignancy.
• It exhibits aggressive behavior and a poor prognosis.
• Symptoms often mimic benign prostatic hyperplasia, complicating diagnosis.

Purpose of the Study:

• To report a case of prostatic stromal sarcoma presenting as benign prostatic enlargement.
• To highlight the diagnostic challenges and aggressive nature of this rare tumor.
• To emphasize the need for early multidisciplinary involvement.

Main Methods:

• Case report of a 51-year-old man with hematuria and obstructive urinary symptoms.
• Diagnostic workup included imaging and prostate-specific antigen levels.
• Surgical intervention (open retropubic prostatectomy) followed by histopathological examination and staging.

Main Results:

• Imaging and low prostate-specific antigen favored benign prostatic enlargement.
• Histopathology unexpectedly revealed prostatic stromal sarcoma.
• Postoperative staging showed extensive locally advanced pelvic disease and pulmonary metastases within weeks.

Conclusions:

• Prostatic stromal sarcoma presents significant diagnostic challenges due to nonspecific symptoms and imaging findings.
• The tumor has an aggressive natural history with rapid progression and distant metastases.
• Heightened clinical suspicion and early multidisciplinary involvement are essential for managing this rare malignancy, especially in resource-limited settings.