Aggressive angiomyxoma of the prostate: A case report

Abstract

Rationale: Aggressive angiomyxoma (AAM) of the prostate should be considered as a differential diagnosis for prostatic tumor presenting with classical symptoms of benign prostatic hypertrophy.

Patient concerns: A 55-year-old man experienced persisting symptoms of prostatic enlargement associated with urinary frequency and urgency and nocturia. Computed tomography images showed low density in the enlarged prostate.

Diagnoses: The diagnosis of AAM of the prostate was confirmed based on histopathological findings.

Interventions: The patient underwent transurethral resection of the prostate.

Outcomes: The patient was enrolled into a watchful waiting protocol. His condition was fine without signs of recurrence on magnetic resonance imaging at the 8-month follow-up.

Lessons: AAM of the prostate should be considered a possible cause of urinary difficulty, including retention, although this may be extremely rare. A reliable diagnosis and complete tumor removal enabled optimal treatment and prevention of tumor recurrence.

Figure 1

Abdominal ultrasonography image showing a mildly enlarged prostate (46 mL) with residual urine of about 168 mL.

Figure 2

Conventional CT image showing a soft tissue mass in the prostate (A). Contrast-enhanced CT scan showing gradual enhancement of sections in the arterial phase (B) and venous phase (C). CT = computed tomography.

Figure 3

Pathological examination of the aggressive angiomyxoma specimen showing scattered spindle cells and myxoid stroma that stain positively with alcian blue (A); immunohistochemical examination showed that the tumor was positive for vimentin (hematoxylin and eosin staining, 100 × ) (B) and negative for S-100 (C). The Ki-67 reaction showed a very low proliferative index of 1% (D).