Expanding the Spectrum of Prostatic Mesenchymal Neoplasm: Clinicopathological Insights From Eight Cases

Mesenchymal neoplasms of prostate make up <1% of tumors occurring in this anatomical location. In this series we discuss 8 cases of prostatic (6) and periprostatic (2) mesenchymal tumors. 100% of the patients are adults with age ranging from 18–70 years. Most common presenting symptom was lower urinary tract obstructive symptoms. 3 out of 8 cases had frank hematuria. Serum PSA was normal in all cases. Radiology (CT scan and MRI) revealed intra-prostatic (6) and peri-prostatic (2) mass lesions. Diagnosis was offered in TRUS and in 4 cases we received radical cystoprostatectomy specimen. We came across 3 cases of prostatic leiomyosarcoma and 1 case each of prostatic rhabdomyosarcoma, undifferentiated pleomorphic sarcoma and clear cell sarcoma. This will be the first case report of primary prostatic clear cell sarcoma to the best of our knowledge. We got 1 case of GIST arising from the recto-vesical pouch and infiltrating into the prostate, and another case of solitary fibrous tumor arising from the periprostatic tissue.All cases in this case series were reported in TRUS biopsy, highlighting the pivotal role of TRUS biopsy in diagnosis, management and prognosis of prostatic and periprostatic lesions. In addition to that, in this case series we discuss a case of clear cell sarcoma of prostate which has not been reported in the English literature. Thus, this case series expands the spectrum of prostatic mesenchymal tumors.