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Case Reports
. 2015 Jan-Mar;7(1):115-9.
doi: 10.4103/0974-7796.148657.

Primary spindle cell sarcoma of the prostate and (18)F-fluorodeoxyglucose-positron-emission tomography/computed tomography findings

Hakan Öztürk  1
Affiliations
Case Reports

Primary spindle cell sarcoma of the prostate and (18)F-fluorodeoxyglucose-positron-emission tomography/computed tomography findings

Hakan Öztürk. Urol Ann. 2015 Jan-Mar.

Abstract

Background: Primary sarcoma of the prostate is extremely rare and accounts for 0.1% of all prostate cancers. This type of cancer is associated with poor prognosis due to aggressive biological behavior. The World Health Organization histologically classified prostate sarcomas as stromal tumor of unknown malignant potential (STUMP) and stromal sarcoma.

Patients and methods: A 39-year-old patient presented with lower urinary tract symptoms over the last few months. On digital rectal examination, the right lobe of the prostate was diffusely hard on palpation. Prostate-specific antigen was 0.5 ng/ml. A biopsy specimen was obtained with the guidance of transrectal ultrasonography. Immunohistochemical examination revealed positive staining for vimentin, actin, and desmin.

Results: (18)F-fluorodeoxyglucose-positron-emission tomography/computed tomography scans obtained for staging purposes with the diagnosis of primary spindle cell carcinoma of the prostate revealed widespread lung and liver metastases. A doxorubicin-based systemic chemotherapy (CTx) was initiated.

Conclusion: Spindle sarcomas of the prostate have quite aggressive nature and they have high potential to metastase. Average life expectancy is <1 year and the prognosis is poor. CTx and radiation therapy can't yield curative effects due to poor differentiation.

Keywords: Diagnosis; positron-emission tomography/computed tomography; prostat cancer; sarcoma; spindle cell prostatic sarcoma; treatment.

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Conflict of interest statement

Conflict of Interest: None.

Figures

Figure 1
Figure 1
(a) The coronal 18F-fluorodeoxyglucose (18FDG)-positronemission tomography/computed tomography scans show, (blue arrow: Primary cancer, green arrow: Bladder FDG accumulation), SUVmax: 12.4, (b) maximum intensity projection images, (blue arrow: Primary cancer, green arrow: Bladder)
Figure 2
Figure 2
(a) The coronal 18F-fluorodeoxyglucose-positron-emission tomography/computed tomography scans show, red arrow: Lung metastasis, SUVmax: 10.9. Blue arrows: Liver metastases SUVmax: 10.3 and 9.6, (b) maximum intensity projection images, (red arrow: Lung metastasis, blue arrows: Liver metastases)
Figure 3
Figure 3
(a) H and E, demonstrating, tumor composed of spindle cells (H and E, ×40), (b) H and E, demonstrating, tumor composed of spindle cells (H and E, ×100), (c) immunohistochemistry showing, desmin (×200), (d) immunohistochemistry showing, actin (×40)
See this image and copyright information in PMC

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