Urinary retention secondary to presacral myelolipoma; first reported case diagnosed by prostate TUR and requiring a cystectomy.

Obstructive voiding symptoms may exceptionally be caused by extrinsic compression. We herein present a singular case of a 68-year-old male that presented with urinary retention and underwent prostate trans-urethral resection (TUR) with histology showing benign prostatic hyperplasia admixed with large amounts of myelolipoma tissue. To the best of our knowledge this is the first reported presacral myelolipoma diagnosed at prostate trans-urethral resection (TUR). Computed tomography revealed a 13 x 9 cm presacral mass displacing the rectum. Even though myelolipomas are regarded as benign, this case behaved aggressively since compressive effect evolved to severe constipation and eventually required a cystectomy.