A Rare Case of Prostatic Extra Gonadal Germ Cell Tumor in a Young Adult: Review of the Literature

We report the case of a 29 year-old male who presented with hemospermia. A biopsy revealed an embryonal rhabdomyosarcoma of the prostate and the patient was treated with pre-operative chemotherapy according to the pediatric protocol IVAD (Ifosfamide - Actinomycin - Doxorubicin – Vincristine) followed by prostatectomy. Pathologic examination of the prostate showed the persistence of an immature teratoma without residual rhabdomyosarcoma. The choice of consolidation chemotherapy with a platinum-based regimen was based on the diagnosis of an extra-gonadal non-seminomatous germ cell tumor with an excellent clinical outcome. Extragonadal germ cell tumors of the prostate in adults are very rare and aggressive. The presence of a sarcomatous component represents a poor prognostic factor and it may pose diagnostic pitfalls just like in the case we report. Early diagnosis and multimodality treatment are necessary to improve overall survival.