Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Mar 15;2024(3):rjae138.
doi: 10.1093/jscr/rjae138. eCollection 2024 Mar.

Leiomyosarcoma of the prostate: a novel approach to treatment-case report and review of the literature

Abdul Baseet Arham  1 , Robert A Robinson  2 , Mohammed Abou Chakra  1 , Michael A O'Donnell  1
Affiliations
Case Reports

Leiomyosarcoma of the prostate: a novel approach to treatment-case report and review of the literature

Abdul Baseet Arham et al. J Surg Case Rep. .

Abstract

Leiomyosarcoma of the prostate is a rare and aggressive tumor, with a quarter of the patients harboring metastatic disease, commonly in the lung. It usually presents with urinary obstruction in a relatively younger patient group. A 29-year-old male presented with lower urinary tract symptoms to the urologist. Computed tomography scan revealed a large pelvic mass involving the prostate. Biopsy on two occasions yielded leiomyoma. Instead of conventional radical surgery, en-bloc resection of the mass was done while preserving the remaining portion of the prostate, seminal vesicles, and ejaculatory duct. Histopathology revealed a high-grade leiomyosarcoma with negative margins. The patient had excellent recovery of defecation, erectile, and ejaculatory functions within 2 months after adjuvant radiotherapy. At the 24-month follow-up there was no evidence of disease. En-bloc resection of the tumor can be considered in select cases to improve functional outcomes and sustain a higher quality of life in patients.

Keywords: LUTS; dysuria; leiomyosarcoma; prostate; prostate cancer; sarcoma.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Contrast CT pelvis (May 2020) showing stable complex solid and cystic pelvic mass abutting displacing the bladder superiorly and the prostate laterally.
Figure 2
Figure 2
MRI Pelvis (contrast) June 2021: well-marginated complex solid, cystic, and septated pelvic mass with multiple sites of enhancement and restricted diffusion; the mass appears to communicate with the bladder neck.
Figure 3
Figure 3
Prostate leiomyosarcoma (high grade/poorly differentiated) 200×: the tumor shows marked nuclear atypia and pleomorphic nuclei.
Figure 4
Figure 4
Contrast CT pelvis at 20 months post-surgery showing no residual disease.
See this image and copyright information in PMC

References

    1. Venyo AK. A review of the literature on primary leiomyosarcoma of the prostate gland. Adv Urol 2015;2015:485786–15. 10.1155/2015/485786. - DOI - PMC - PubMed
    1. Sexton WJ, Lance RE, Reyes AO, Pisters PW, Tu SM, Pisters LL. Adult prostate sarcoma: the M. D. Anderson Cancer Center Experience. J Urol 2001;166:521–5. 10.1016/s0022-5347(05)65974-5. - DOI - PubMed
    1. Hansel DE, Herawi M, Montgomery E, Epstein JI. Spindle cell lesions of the adult prostate. Mod Pathol 2007;20:148–58. 10.1038/modpathol.3800676. - DOI - PubMed
    1. Miedler JDM, Gregory T. Leiomyosarcoma of the prostate. J Urol 2007;178:668. 10.1016/j.juro.2007.05.036. - DOI - PubMed
    1. Raj DH, Dash PK, Mohanty J, Sarangi PK. Leiomyosarcoma of the prostate-an unexpected histopathological outcome. BMJ Case Rep 2016;2016:bcr2016215594. 10.1136/bcr-2016-215594. - DOI - PMC - PubMed

Publication types