A rare prostatic tumour masquerading clinically as benign prostatic hyperplasia

Prostatic tumours are usually benign. Malignant tumours are usually adenocarcinoma. Rare benign prostate tumours include inflammatory myofibroblastic tumours, which can be found in various body parts and are frequently identified in the lung or abdominal cavity of children and young adults. Inflammatory myofibroblastic tumours of the urinary tract present more often in kidneys. Prostatic inflammatory myofibroblastic tumours are sporadic and rare. Presenting 44 years old male with complaints of gross hematuria for 15 days with recurrent urine retention. Per rectal examination revealed, grade II prostate enlargement was firm in consistency. PSA was mildly raised (4.4 ng/ml). Ultrasound abdomen showed enlarged prostate (volume -40 cc) with irregular margins and heterogeneous echo texture showing increased flow on colour Doppler. Transrectal ultrasound (TRUS) showed a well-defined irregular heterogeneously echoic mass in the transitional zone, but TRUS biopsy showed no malignancy. After TURP, prostate chip examination showed inflammatory myofibroblastic pseudotumour of the prostate. Di?erentiation of inflammatory myofibroblastic prostate tumours from malignant tumours through imaging and laboratory tests is di?cult. A case of prostatic inflammatory myofibroblastic tumour observed after transurethral resection of the prostate to treat prostate hyperplasia in a 44-year-old man is presented in this report.

Prostatic tumour markers in BPH and prostate cancer.

The blood levels of acid phosphatase (AP), prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) in 80 cases of begin prostatic hypertrophy (BPH) patients and 22 cases of prostate cancer patients were studied. It was shown that the average levels of AP, PAP and PSA in BPH patients were 4.06 U/L, 1.27 U/L and 7.45 ng/ml. respectively, while those in prostate cancer patients were 5.09 U/L, 1.63 U/L and 62.63 ng/ml. respectively. In a comparison between the two groups of patients, the levels of AP and PAP were not found to be significantly different (p > 0.05), whereas in the case of PSA there was a significant difference (p < 0.005). Therefore, although AP and PAP cannot be used to differentiate between BPH and prostate cancer, PSA could be utilized However, no exact level of PSA was observed which would allow differentiation between the groups because although the PSA levels in 64 per cent of the BPH patients were higher than normal none were over 40 ng/ml.; those in 14 per cent of prostate cancer were normal. There was correlation between PSA level and adenoma tissue weight, from TUR-P, with an average value of 0.35 ng/ml. per 1 gram of tissue. It is import to note that in a patient who has a PSA level of over 40 ng/ml., or a PSA level that has no correlation to the weight of the prostate, there is a high possibility of prostate cancer. Therefore, a pathological tissue examination should be approved for this patient.