Sutrakar S.K., Singh U.R., Sharma B.K., Singh
V. and Sulya M.
S.S. Medical
College and Asso. S.G.M. Hospital, Rewa (Madhya Pradesh)
ABSTRACT:
Benign prostatic
hyperplasia (BPH) is common in elderly males. However, benign mesenchymal
tumors, especially pure leiomyoma, are rare in prostate. The diagnosis of is
important because of the potential of malignancy in such cases, histopathology
is only tool to diagnose and to rule out the malignant changes. Here we report
the case of pure leimyoma prostate diagnosed on sonography as benign prostatic
hyperplasia.
KEY-WORDS: Mesenchymal tumors, Leiomyoma,
BPH, Malignancy, Prostate.
INTRODUCTION:
Introduction:
Pure leiomyoma of the
prostatic is a rare disease, which is believed to originate from smooth muscle
element of peri-glandular prostatic tissue, the prostatic capsule or the
mullerian duct remnant. It is defined specifically as a circumscribed and
encapsulated mass of smooth muscle, 1cm or more in diameter, containing varying
amount of fibrous tissue ( devoid of glandular elements) which is either
obviously prostatic or juxtraprostatic in origin and position.
Case Report:
A 66 year-old man
presented with several months history of progressive bladder outlet obstruction
culminating in acute urinary retention. Last 1 year patient is catherised,
patient currently complaining of burning in micturation, on sonography prostate
is enlarged in size, it weighs 49 gms. Echo texture of prostatic tissue is
heterogeneous and projection of median lobe into urinary bladder is noted. The
urinary bladder finding shows partially full Foleys is seen in situ, the mucosa
appears thickened.
We received an excised
prostatic soft tissue mass, grossly measuring 3cmX2cmX2cm in size, nodular,
firm in consistency, well circumscribed, white in colour. Outer surface smooth and
on cut shows whorled trabecular appearance. (figure.1).
Microscopic H and E
section shows fascicle of eosinophilic spindle cells intersecting right angle
to each other. The nuclei are oval to plump with no nuclear atypia and scanty
cytoplasm. Section shows a thick walled vessel favoring a cellular smooth
muscle neoplasm. No glandular tissue
seen in examined section, indicating the pure leiomyoma of prostate.
(Figure.2.).
DISCUSSION:
The normal
prostate consists of smooth muscle, glandular and connective tissue. Hence
leiomyomatous nodules are not infrequently found in benign nodular hyperplasia
of the prostate¹. The features are an absence of a glandular component and the
presence of a capsule or pseudo capsule²; these may or may not be accompanied
by BPH. On MRI normal prostatic glandular tissue could be clearly distinguish
from tumor ³. Pure prostatic leiomyomas is very rare 3, 4, 5, 6, and 8.
So far 70 cases have been reported. . Histopathological examination is a
confirmatory diagnosis of a solitary nodule of prostate 4, 6, and 7.
CONCLUSION:
The
hallmark of histological diagnosis of leiomyoma is presence of thick walled
blood vessel and presence of spindle cells. The early recognition of this
lesion helps in better management of the patient.
Abbreviations:
. BPH
-Benign Prostatic Hyperplasia
. MRI-
Magnetic Resonance Imaging
. H and E-Haematoxylin
and Eosin
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Received on 05.09.2011
Accepted on 30.09.2011
© A&V Publication all right reserved
Research J. Pharmacology and
Pharmacodynamics. 3(6): Nov.-Dec., 2011, 297-298