Prostatic aggressive angiomyxoma (AAM) with initial presentation of urinary obstruction: a rare case report and literature review.

Background: Aggressive angiomyxoma (AAM) is a rare benign mesenchymal tumor known for its aggressive behavior and high recurrence rates, with male cases of AAM being less frequently reported. This study presents a rare case of primary prostatic AAM characterized by a prostatic urethral mass obstructing the bladder outlet, resulting in acute renal dysfunction.

Case description: The 51-year-old male patient presented with lumbar pain, nausea, frequent urination, urgency, and incomplete urination. Laboratory test indicated increased levels of serum creatinine and potassium. Emergency bedside ultrasound found giant bilateral hydronephrosis. The patient received emergent potassium-lowering therapy and bilateral nephrostomy. Computed tomography (CT) revealed a 3.7 cm × 2.3 cm low-density soft tissue mass in prostate. Transurethral resection of the prostatic mass was performed. Pathological examination identified the presence of deep-seated AAM. For fear of recurrence, he underwent radical prostatectomy. Postoperative histopathology showed no sign of residual tumor. He recovered uneventfully and is now under regular follow-up.

Conclusions: AAM is a rarely reported locally aggressive mesenchymal neoplasm characterized by high recurrence, which was even rarer in prostate. As we know, this is the first case of prostatic AAM treated by both transurethral resection and further radical resection. In this case, the tumor was completely excised surgically, but long-term follow-up is required to monitor for recurrence.