A Prostatic Extra-Gastrointestinal Stromal Tumor Treated by Surgery: A Case Report with 7-Year Follow-Up and Review of Literature.

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.