Sarcoma of prostate: case report and review of the literature.
OBJECTIVE
Prostate sarcomas are rare entity, the most common is leiomyosarcoma which account for 0.1% of all prostate malignancies. The presenting symptoms are mainly obstructive urinary symptoms. Surgery with chemo- or radiotherapy are the mainstay treatment options. The overall survival rate remains poor regardless of initial tumour size, grade or histological subtype. Immunohistochemistry reveals tumour cells diffusely positive for vimentin, smooth muscle actin, focally positive for progesterone receptor, whilst keratins are usually negative.


METHODS
We describe a case of a patient affected by sarcoma of prostate. Furthermore, we reviewed the cases of prostate sarcomas available in literature to clarify the best therapeutic options to be applied.


RESULTS
In the case described leiomyosarcoma diagnosed by an ultrasound guided biopsy was characterized by fascicles of spindle-shaped cells with a variable degree of nuclear atypia. The immunohistochemistry showed positive staining for smooth muscle actin, vimentin and focally for the S-100 protein. The patient was treated with radical retropubic prostatectomy and radiotherapy of the local recurrence, and chemotherapy at metastases onset.


CONCLUSIONS
Prostate sarcomas are highly aggressive, with limited therapeutic options. An early diagnosis and complete surgical excision with negative margins offer patients the long-term disease free survival.
Pace
Gianna
G
Department of Health Sciences, University of L'Aquila, L'Aquila, Italy. giannapace@gmail.com
Pomante
Roberto
R
Vicentini
Carlo
C
D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000628:therapy; D012509:Sarcoma / Q000175:diagnosis / Q000628:therapy