Atypical smooth muscle neoplasia of the prostate of uncertain malignant potential – leiomyoma/leimyosarcoma of the prostate

Overview

Juhász Á, Matějková M, Záleský M, Belej K. Atypical smooth muscle neoplasia of the prostate of uncertain malignant potential –⁠ leiomyoma/ leimyosarcoma of the prostate.

Both prostate leiomyoma and leiomyosarcoma are extremely rare mesenchymal prostate tumors. 

The prognosis and therapy of these diseases is however significantly different. We present a case of a 54-year-old man who was found to have a paraprostatic lesion with low prostate specific antigen during a rectal examination. Transrectal prostate biopsy was performed, followed by pelvic magnetic resonance imaging and rectoscopy. None of the examinations confirmed the presence of malignant cells or the suspicion of malignancy. The is asymptomatic patient was followed up by his outpatient urologist for two years. With the development of symptoms a control MRI of the pelvis was indicated with the finding of growth progression of the lesion with central necrotization and with suspicion of malignant character, which already oppressed the prostate and part of the urethra. For the findings described above pelvic revision was indicated with an eventual radical prostatectomy. Histological examination of the specimen from robotic assisted radical prostatectomy showed atypical smooth muscle neoplasia of the prostate of uncertain malignant potential –⁠ leiomyoma with borderline changes with leiomyosarcoma.

Keywords:

Leiomyoma – Leiomyosarcoma – Prostate carcinoma