Prostatic sarcoma is a very rare tumour arising from the specialized stroma of the prostatic parenchyma. The clinical and histological features and biological behaviour of this entity are poorly elucidated at the present time. The authors report a case of prostatic stromal sarcoma in a 47-year-old man presenting with complete bladder retention. The initial diagnosis was that of benign prostatic hyperplasia and the patient was treated by suprapubic prostatectomy with no other complementary treatment. Histological examination demonstrated primary neuroectodermal tumour (PNET). The patient was subsequently lost to follow-up and was only reviewed 22 months later in a context of haematuria. Digital rectal examination revealed a large, soft prostate with an estimated weight of 83 grams on ultrasound. Transurethral resection was performed and histological examination of the resection material and review of the slides of the primary tumour showed identical microscopic and immunohistochemical features, corresponding to stromal sarcoma. The patient was treated by local and regional radiotherapy (60 Grays). With a follow-up of 36 months, he presents urinary symptoms with no signs of local extension or metastasis.
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