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

J Surg Case Rep. 2024 Mar 15;2024(3):rjae138. doi: 10.1093/jscr/rjae138. eCollection 2024 Mar.

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.

Publication types

  • Case Reports