Borderline phyllodes tumor of the prostate(a case report and literature review) / 中华泌尿外科杂志

ABSTRACT

Objective To review the clinical manifestation,pathological characteristics,treatment and prognosis of borderline phyllodes tumor of the prostate. Methods A case of borderline phyllodes tumor of the Prostate was reported and relative literature was reviewed. Results A 32-year-old man was admided to hospital with a history of aggravated dysuria 2 weeks and urinary retchtion one day. The enlarged prostate was palpated softly and smoothly by DRE.The serum PSA was 20.62 ng/ml.Transrectal ultrasonography and MRI revealed a well-demarcated poly-cystiform tumor which compressed the right lobe of the prostate to flattening.The diagnosis of benign stroma tumor which was not differentiated maturity obtained after transrectal sextant needle biopsy,and the transvesical enucleation was performed under epidural anesthesia.The tumor was histologically diagnosed as borderline phyllodes tumor of the prostate. Microscopic examination showed the tumor was composed of epithelial and stroma cells.The stroma cells proliferated obviously with atypia and mitosis,and the epithelial cells propagated without atypia.Immunohistochemical staining was performed.Vimentin was typically positive,PSA and PAP was positive,and SMA was negative.Forty days after the enucleation,the tumor recurrenced then radical prostatectomy was performed.The diagnosis of low potential malignant phyllodes tumor of the prostate was made.The tumor was limited in tegument and the cross-section of urethra was infiltrated.The patient received external radiation to the whole pelvis(66 Gy)1 month postoperatively.At 6 months'follow up,the patient was asymptomatae. Conelusions The right diagnosis can not be obtained by needle biopsy because hyperptastic epithelial cells can not get and the recurrences of phyllodes tumor increase malignant potential.Radical prostatectomy is the most reliable method of treatment at present.