Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2020; 8(18): 4215-4222
Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4215
Robotic surgery in giant multilocular cystadenoma of the prostate: A rare case report
Le-Wei Fan, Ying-Hsu Chang, I-Hung Shao, Kuei-Fang Wu, See-Tong Pang
Le-Wei Fan, Ying-Hsu Chang, I-Hung Shao, See-Tong Pang, Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
Kuei-Fang Wu, Department of Pathology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
Author contributions: Fan LW and Chang YH are the first authors of the above case report; Fan LW wrote the case report and completed the literature review; Chang YH made critical revisions and finalized manuscript; Shao IH made English editing; Wu KF is an attending pathologist; Pang ST is an attending urologist and the operator of this case; Pang ST performed the final editing and preparation of the paper for approval; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and the accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: See-Tong Pang, MD, PhD, Attending Doctor, Chief Doctor, Professor, Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, No. 5 Fuxing Street, Guishan District, Taoyuan 333, Taiwan. jacobpang@cgmh.org.tw
Received: April 2, 2020
Peer-review started: April 2, 2020
First decision: April 24, 2020
Revised: April 27, 2020
Accepted: August 27, 2020
Article in press: August 27, 2020
Published online: September 26, 2020
Abstract
BACKGROUND

Giant multilocular cystadenoma (GMC) of the prostate gland is a very rare benign tumor. Although the benign nature has been known, complete surgical excision is the major treatment consensus because of its high recurrence rate. We report a rare case of GMC with accompanying lower urinary tract symptoms and repeated urine retention initially thought to be symptoms of benign prostatic hyperplasia, which was treated with robot-assisted laparoscopic radical prostatectomy.

CASE SUMMARY

A 65-year-old man presented with a 2-year history of lower urinary tract symptoms that had deteriorated gradually within the previous six months, even though he had received treatment with a selective alpha-blocking agent. He had undergone two transurethral resections of the prostate (TURP) at a local hospital during a 4-mo interval because initial ultrasound imaging and prostatic core needle biopsy showed benign prostate hyperplasia. Upon the third recurrence, the patient underwent TURP with a green-light laser at our institution. The diagnosis was a tumor composed of variously sized dilated glandular and cystic structures lined by blended prostatic type epithelia positive for prostate-specific antigen; the final diagnosis was giant multilocular cystadenoma. Magnetic resonance imaging showed a large multilocular retrovesical mass 8.0 cm × 7.3 cm × 6.4 cm, with heterogeneous enhancement. A coexisting malignant part could not be excluded. Considering the high recurrence rate, risk of coexisting malignancy, and possible sequelae of open surgery for radical excision, the patient decided to undergo robot-assisted radical prostatectomy, with good outcomes at the 2-year follow-up.

CONCLUSION

Robot-assisted surgery for the treatment of prostate GMC provides another choice for simultaneous attention to disease-control and postoperative quality of life.

Keywords: Giant multilocular cystadenoma, Prostate gland, Robotic surgery, Radical prostatectomy, Continence and erectile function, Case report

Core Tip: Giant multilocular cyst adenoma (GMC) of the prostate is a rare benign tumor without specific clinical manifestations that can easily be misdiagnosed as BPH due to obstructive urinary symptoms. We recommend individualized treatment of this rare tumor and provide our experience in the first case of prostatic GMC treated with robot-assisted radical prostatectomy that resulted in a good outcome.