Published online Feb 6, 2020. doi: 10.12998/wjcc.v8.i3.606
Peer-review started: December 7, 2019
First decision: December 23, 2019
Revised: December 27, 2019
Accepted: January 8, 2020
Article in press: January 8, 2020
Published online: February 6, 2020
Prostatic stromal sarcoma presenting with rhabdoid features is extremely rare, and only four cases have been reported in the English-language literature to date. Accordingly, there is no absolute definition of this group of tumors as yet, and our overall understanding of its morphological features, therapeutic regimen and prognosis is limited.
A 34-year-old male patient was referred to our hospital to address a 2-mo history of hematuria and progressive dysuria. Pelvic computed tomography scan revealed a 6.0 cm × 5.2 cm × 7.2 cm mass in the prostate, with bladder invasion. The patient underwent transurethral prostatectomy as upfront therapy. He refused further treatment and died of uncontrollable tumor growth 3 mo after surgery. Pathology analysis revealed the stroma to be pleomorphic, with a huge number of atypical spindle cells. Rhabdomyoblastic cells, with abundant eosinophilic cytoplasm, were detected. The spindle cells were positive for vimentin, INI1 and β-catenin, and the rhabdomyoblastic cells were positive for MyoD1, myogenin and INI1. The spindle cells and epithelial cells were sporadically positive for P53.
The prostatic stromal sarcoma tumor was immunoreactive for β-catenin, suggesting a role for the Wnt/β-catenin pathway in this tumor type.
Core tip: An extremely rare case of prostatic stromal sarcoma is presented. The rhabdoid component represented only a minor part of the tumor, as revealed by pathology study. Detailed diagnostic information on this rare tumor type has been reported in the literature, although the molecular pathogenesis remains largely unknown. The β-catenin immunoreactivity of the tumor in our case suggests that the tumorigenesis process may involve the Wnt pathway.