Solitary Fibrous Tumor of the Prostate: What is the Optimal Treatment? Description of A Case and Review of the Pertinent Literature

IF 0.1 Q4 UROLOGY & NEPHROLOGY Journal of Urological Surgery Pub Date : 2023-06-05 DOI:10.4274/jus.galenos.2022.2022.0054
H. Yılmaz, I. E. Avci, C. Özkürkçügil, Emre Özcan, A. Eruyar
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Abstract

A solitary fibrous tumor (SFT) originating from the prostate has been rarely reported, presenting the 44 th case. We evaluated a 44-year-old man who presented with a two-year history of pressure in the lower abdomen. On magnetic resonance imaging, a 48×66 mm, well-circumscribed mass was observed. 12-core prostatic needle biopsy was performed. Histological examination reported hypocellular and hypercellular areas composed of bland spindle cells arranged in a haphazard pattern. One or two mitotic figures were observed per 10 high-power-fields. Immunohistochemistry analysis showed a strong expression of CD34, STAT-6, and vimentin by tumor cells. We conducted a surveillance protocol for the patient due to the avoidance the surgery. Although there was an increase of approximately 2 cm in tumor diameter, no change was detected in tumor cellularity, number of mitosis, and other histopathological findings in complementary prostatic needle biopsy after three years of follow-up. A literature review of all prostatic SFTs was performed on histopathological features, treatment modality, and reported recurrence and progression data to identify optimal treatment. Local recurrence was reported in five (11.6%) cases and metastasis in two (4.7%) cases. Twenty-two patients underwent radical surgery with a negative margin. None of these had local recurrence and metastasis was reported in only one. Palliative surgery was reported in 18 patients, including five with local recurrence. However, six had no local recurrence or metastasis during the reported follow-up period. Careful surveillance can be conducted in informed patients if there is no malignancy in the histopathologic examination. In all other cases, surgery is strongly advised and should be radical rather than palliative.
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孤立性前列腺纤维性肿瘤:最佳治疗方法是什么?个案描述及相关文献回顾
孤立的纤维性肿瘤(SFT)起源于前列腺已经很少报道,提出了第44例。我们评估了一位44岁的男性,他表现出两年的下腹部压力史。在磁共振成像上,观察到一个48×66 mm,边界清楚的肿块。行12芯前列腺穿刺活检。组织学检查报告细胞少区和细胞多区由淡色梭形细胞组成,排列杂乱无章。每10个高倍视场观察到1或2个有丝分裂象。免疫组化分析显示肿瘤细胞强烈表达CD34、STAT-6和vimentin。由于避免手术,我们对患者进行了监测。虽然肿瘤直径增加了约2cm,但随访3年后,补充前列腺穿刺活检的肿瘤细胞、有丝分裂数及其他组织病理学检查未见变化。对所有前列腺SFTs的文献进行回顾,包括组织病理学特征、治疗方式、报告的复发和进展数据,以确定最佳治疗方法。局部复发5例(11.6%),转移2例(4.7%)。22例患者接受了阴性切缘的根治性手术。这些病例均无局部复发,仅有一例报道有转移。18例患者行姑息性手术,其中5例局部复发。然而,在报告的随访期间,6例没有局部复发或转移。如果在组织病理检查中没有恶性肿瘤,可以在知情的患者中进行仔细的监测。在所有其他情况下,强烈建议手术,手术应该是根治性的,而不是姑息性的。
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来源期刊
Journal of Urological Surgery
Journal of Urological Surgery UROLOGY & NEPHROLOGY-
自引率
33.30%
发文量
42
审稿时长
16 weeks
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