Prostate puzzle: Unconventional prostatic STUMP findings in a middle-aged patient prompt closer examination

Q4 Medicine

Radiology Case Reports Pub Date : 2024-11-22 DOI:10.1016/j.radcr.2024.10.104

Mohammadrzea Elhaie , Abolfazl Koozari , Mohammad Reza Khademi

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引用次数: 0

Abstract

A 41-year-old male presented with obstructive urinary symptoms and an enlarged prostate. Subsequent testing revealed a remarkably high PSA level of 150 ng/mL, considerably above normal limits, raising concern for possible malignancy. Transrectal ultrasound showed an enlarged heterogeneous prostate measuring 74×80×75mm. PSMA PET/CT detected intense tracer uptake. While MRI and biopsy ruled out carcinoma, they indicated Stromal Tumors of Uncertain Malignant Potential (STUMP), an uncommon diagnosis in younger patients. This complex case highlights the essential role of advanced multimodal imaging and immunohistochemistry in diagnosing atypical prostatic lesions of uncertain malignant potential like STUMP, given their histologic similarity to benign conditions posing diagnostic difficulties. A multidisciplinary approach led to the STUMP diagnosis and decision for long-term monitoring instead of radical prostatectomy due to STUMP's unpredictable behavior. This report reinforces the need for diligence when evaluating seemingly benign but diagnostically challenging presentations that could conceal conditions like STUMP, and the importance of a multidisciplinary approach for accurate diagnosis and management of such rare prostatic proliferations.

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前列腺之谜：一名中年患者的非常规前列腺 STUMP 发现促使我们进行更仔细的检查

一名 41 岁的男性出现泌尿系统梗阻症状和前列腺增生。随后的检查发现，前列腺特异抗原（PSA）水平高达 150 纳克/毫升，大大超过了正常值，令人担心可能是恶性肿瘤。经直肠超声检查显示前列腺增大，大小为 74×80×75mm。PSMA PET/CT 检测到强烈的示踪剂摄取。虽然核磁共振成像和活组织检查排除了癌症的可能性，但却显示存在恶性潜能不确定的间质瘤（STUMP），这在年轻患者中并不常见。这个复杂的病例凸显了先进的多模态成像和免疫组化技术在诊断STUMP等恶性潜能不确定的非典型前列腺病变中的重要作用，因为它们在组织学上与良性病变相似，给诊断带来了困难。由于 STUMP 的行为难以预测，多学科方法导致了 STUMP 的诊断，并决定进行长期监测，而不是根治性前列腺切除术。本报告强调，在评估看似良性但诊断困难的病例时，需要谨慎对待，因为这些病例可能隐藏着 STUMP 等病症，同时也强调了多学科方法对于准确诊断和处理此类罕见前列腺增生症的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiology Case Reports Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

1.10

自引率

0.00%

发文量

1074

审稿时长

30 days

期刊介绍： The content of this journal is exclusively case reports that feature diagnostic imaging. Categories in which case reports can be placed include the musculoskeletal system, spine, central nervous system, head and neck, cardiovascular, chest, gastrointestinal, genitourinary, multisystem, pediatric, emergency, women''s imaging, oncologic, normal variants, medical devices, foreign bodies, interventional radiology, nuclear medicine, molecular imaging, ultrasonography, imaging artifacts, forensic, anthropological, and medical-legal. Articles must be well-documented and include a review of the appropriate literature.