M K Terris1. 1. Section of Urology, Palo Alto Veterans Affairs Health Care System, California 94304, USA. mkt@icon.palo-alto.med.va.gov
Abstract
BACKGROUND: Delayed development of prostatic sarcoma is a rare complication of prostatic pelvic irradiation. The transrectal ultrasound appearance of this lesion has not been previously described. METHODS: Three cases of radiation-induced prostatic sarcoma are presented, with emphasis on the transrectal ultrasound findings. RESULTS: An irregular, hypoechoic prostatic mass with an anechoic area consistent with the echogenicity of muscle and/or necrosis was found in all 3 patients. This appearance is distinctly dissimilar from prostatic adenocarcinoma. CONCLUSIONS: The sonographic finding of an irregular, hypoechoic prostatic mass with an anechoic area should raise suspicion for prostatic sarcoma in patients with a history of pelvic irradiation who develop an abnormal prostate on rectal examination and/or worsening voiding symptoms despite a normal serum prostate-specific antigen level.
BACKGROUND: Delayed development of prostatic sarcoma is a rare complication of prostatic pelvic irradiation. The transrectal ultrasound appearance of this lesion has not been previously described. METHODS: Three cases of radiation-induced prostatic sarcoma are presented, with emphasis on the transrectal ultrasound findings. RESULTS: An irregular, hypoechoic prostatic mass with an anechoic area consistent with the echogenicity of muscle and/or necrosis was found in all 3 patients. This appearance is distinctly dissimilar from prostatic adenocarcinoma. CONCLUSIONS: The sonographic finding of an irregular, hypoechoic prostatic mass with an anechoic area should raise suspicion for prostatic sarcoma in patients with a history of pelvic irradiation who develop an abnormal prostate on rectal examination and/or worsening voiding symptoms despite a normal serum prostate-specific antigen level.