Onset of hydronephrosis and lower urinary tract symptoms in a previously healthy young man: Phyllodes tumour of the prostate as a potential diagnosis

Abstract

We report the case of a 50-year-old healthy man with early onset of micturition symptoms associated with an elevated total prostate-specific antigen. On physical examination, we found an enlarged prostate; a first-line ultrasound of the urinary tract revealed local disease which covered the entire small pelvis. A computed tomography scan confirmed the presence of a 12.5 × 11.0 × 9.5-cm multicystic prostatic mass, compressing the bladder and pelvic ureters, associated with right hydronephrosis. Renal function was preserved and prostatic biopsies was negative for malignant disease. The mass was completely removed through transvesical approach and histological analysis diagnosed a low-grade phyllodes tumour of the prostate. The patient was free of local recurrence and metastasis 36 months after surgery.

Fig. 1a.

Axial computed tomography image showing the large prostatic mass with cystic components that compresses the bladder.

Fig. 1b.

Coronal computed tomography (CT) image showing right hydronephrosis.

Fig. 2a.

Microscopic images demonstrating the epithelial and stromal components of the cystic tumour.

Fig. 2b.

Microscopic images demonstrating the actin-positivity of stromal cells.