Prostate sarcomatoid carcinoma as accidental finding in transurethral resection of prostate specimen. A case report and systematic review of current literature.

BACKGROUND: Sarcomatoid carcinoma of the prostate is an extremely rare and highly aggressive neoplasm that accounts for less than 0.1% of primary prostate malignancies. Long-term survival rates for adult patients with prostate sarcomatoid carcinoma are poor. Surgical treatment seems to be the most effective therapeutic approach. In contrast radiation therapy alone has shown limited efficacy. AIM: The purpose of the study is to present a case of sarcomatoid carcinoma of the prostate treated with a combination of radiotherapy and TURP. CASE REPORT: A 76-year-old man treated with TURP due to acute urinary retention was finally diagnosed with sarcomatoid carcinoma upon pathology examination of the surgical specimen. Patient was initially treated with external beam radiotherapy. Six months later, he presented with urinary retention suggesting extension of the tumor into the bladder neck. Pathology report diagnosed prostate sarcomatoid carcinoma containing also large areas of necrosis. Patient underwent an extensive TURP and he received a second round radiotherapy. One year after the initial diagnosis of sarcomatoid carcinoma, patient is free of symptoms and follow up investigation shows no evidence of metastatic disease.
CONCLUSIONS: Radiation therapy in combination with extensive TURP may delay disease progression.