{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:41:21Z","timestamp":1772995281302,"version":"3.50.1"},"reference-count":35,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Primary prostatic stromal sarcoma is an exceptionally rare urological malignancy, constituting less than 0.1% of all prostatic cancers. It poses a significant clinical challenge due to its aggressive behavior and poor prognosis. Materials and Methods: We report the case of a 34-year-old male who presented with nonspecific lower urinary tract symptoms, including dysuria and increased urinary frequency. The initial diagnostic workup, including digital rectal examination and Magnetic Resonance Imaging (MRI), revealed a lobulated lesion within the prostate. A transurethral resection (TUR) was performed for diagnostic purposes, and histopathological examination revealed a \u201cmalignant mesenchymal tumor\u201d. The patient underwent a laparoscopic radical prostatectomy. The pathology report confirmed the diagnosis of prostatic stromal sarcoma. The postoperative follow-up, including systemic CT and MRI, showed no evidence of recurrence or metastasis thus far. Results: Multidisciplinary management is essential for optimizing treatment outcomes in all urologic malignancies; however, it becomes particularly challenging and crucial in rare cases such as primary prostatic stromal sarcoma. In our case, the patient benefited from a coordinated approach involving urology, pathology, and oncology, underscoring the importance of collaborative care for rare and aggressive tumors like this. This case highlights the importance of early detection, complete surgical excision, and consideration of adjuvant therapies, given the aggressive nature of the disease. The role of novel therapeutic strategies, including immunotherapy and targeted therapies, is also discussed in the context of metastatic sarcomas. Conclusions: This case underscores the critical need for a comprehensive, multidisciplinary approach to managing primary prostatic stromal sarcoma. Ongoing research on innovative therapies offers hope for improved outcomes in metastatic stages.<\/jats:p>","DOI":"10.3390\/medicina60121918","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T04:21:36Z","timestamp":1732249296000},"page":"1918","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Primary Prostatic Stromal Sarcoma: A Case Report and Review of the Literature"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2487-2087","authenticated-orcid":false,"given":"Enes","family":"Erul","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara 06620, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d6mer","family":"G\u00fclp\u0131nar","sequence":"additional","affiliation":[{"name":"Department of Urology, Ankara University Faculty of Medicine, Ankara 06620, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Di\u011fdem","family":"Kuru \u00d6z","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ankara University Faculty of Medicine, Ankara 06620, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Havva","family":"Berber","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ankara University Faculty of Medicine, Ankara 06620, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saba","family":"Kiremitci","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ankara University Faculty of Medicine, Ankara 06620, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y\u00fcksel","family":"\u00dcr\u00fcn","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara 06620, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1002\/pros.24758","article-title":"Analysis of three primary prostatic sarcoma cases and literature review","volume":"84","author":"Wei","year":"2024","journal-title":"Prostate"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S133","DOI":"10.1038\/modpathol.2017.155","article-title":"Mesenchymal tumors of the prostate","volume":"31","author":"McKenney","year":"2018","journal-title":"Mod. Pathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/S0022-5347(05)65974-5","article-title":"Adult prostate sarcoma: The M. D. Anderson Cancer Center Experience","volume":"166","author":"Sexton","year":"2001","journal-title":"J. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.asjsur.2020.06.004","article-title":"Adult primary prostate sarcoma: A multi-center cohort study and comparison between Chinese and American cases","volume":"44","author":"Ding","year":"2021","journal-title":"Asian J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"797","DOI":"10.4111\/kju.2014.55.12.797","article-title":"Histologic variability and diverse oncologic outcomes of prostate sarcomas","volume":"55","author":"Sohn","year":"2014","journal-title":"Korean J. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s13000-017-0640-5","article-title":"A rare case of malignant solitary fibrous tumor in prostate with review of the literature","volume":"12","author":"Ronchi","year":"2017","journal-title":"Diagn. Pathol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"115","DOI":"10.4103\/0974-7796.148657","article-title":"Primary spindle cell sarcoma of the prostate and (18)F-fluorodeoxyglucose-positron-emission tomography\/computed tomography findings","volume":"7","year":"2015","journal-title":"Urol. Ann."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"rjaa165","DOI":"10.1093\/jscr\/rjaa165","article-title":"A case of prostate stromal sarcoma involving the rectum","volume":"2020","author":"Ueda","year":"2020","journal-title":"J. Surg. Case Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"184","DOI":"10.5534\/wjmh.2014.32.3.184","article-title":"Diagnosis of a gastrointestinal stromal tumor presenting as a prostatic mass: A case report","volume":"32","author":"Huh","year":"2014","journal-title":"World J Men\u2019s Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1148\/rg.2016150226","article-title":"Beyond Prostate Adenocarcinoma: Expanding the Differential Diagnosis in Prostate Pathologic Conditions","volume":"36","author":"Li","year":"2016","journal-title":"RadioGraphics"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e0495","DOI":"10.1097\/MD.0000000000010495","article-title":"Prostatic stromal sarcoma: A case report and literature review","volume":"97","author":"Yang","year":"2018","journal-title":"Medicine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S1078-1439(03)00120-0","article-title":"Adult prostate sarcoma diagnosed from tissue spontaneously excreted through the urethra","volume":"22","author":"Froehner","year":"2004","journal-title":"Urol. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s13000-022-01198-4","article-title":"ARID1A deficient undifferentiated spindle cell and rhabdoid sarcoma of the prostate: Report of a unique case with emphasis on diagnostic implications","volume":"17","author":"Xu","year":"2022","journal-title":"Diagn. Pathol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/RLU.0000000000002372","article-title":"18F-FDG PET\/CT Imaging in an Adolescent Patient with Primary Prostatic Stromal Sarcoma","volume":"44","author":"Lai","year":"2019","journal-title":"Clin. Nucl. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e353","DOI":"10.1200\/JCO.2012.41.7758","article-title":"Favorable Response to Neoadjuvant Chemotherapy and Radiation in a Patient with Prostatic Stromal Sarcoma","volume":"30","author":"Reese","year":"2012","journal-title":"J. Clin. Oncol."},{"key":"ref_16","first-page":"1764","article-title":"A young man with primary prostatic extra-gastrointestinal stromal tumor: A rare case report and review of the literature","volume":"7","author":"Zhang","year":"2014","journal-title":"Int. J. Clin. Exp. Pathol."},{"key":"ref_17","first-page":"252805","article-title":"Primary sarcoma of the specialised prostatic stroma: A case report and review of the literature","volume":"2011","author":"Zamparese","year":"2011","journal-title":"Case Rep. Pathol."},{"key":"ref_18","first-page":"100221","article-title":"Prostatic stromal sarcoma\u2014Management course of a rare presentation: A case report","volume":"9","author":"Salih","year":"2023","journal-title":"Curr. Probl. Cancer Case Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1007\/s13193-017-0660-3","article-title":"Prostatic High-Grade Stromal Sarcoma\u2014A Rare Encounter","volume":"8","author":"Rao","year":"2017","journal-title":"Indian J. Surg. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1007\/s13691-022-00552-z","article-title":"Detection of relatively poor but definitive blood supply in prostate stromal sarcoma using transrectal ultrasonography with superb microvascular imaging","volume":"11","author":"Ohashi","year":"2022","journal-title":"Int. Cancer Conf. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1080\/02841860310014732","article-title":"A systematic overview of radiation therapy effects in soft tissue sarcomas","volume":"42","author":"Strander","year":"2003","journal-title":"Acta Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"815","DOI":"10.6004\/jnccn.2022.0035","article-title":"Soft Tissue Sarcoma, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology","volume":"20","author":"Kane","year":"2022","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e2021053127","DOI":"10.1542\/peds.2021-053127","article-title":"Long-term Follow-up Care for Childhood, Adolescent, and Young Adult Cancer Survivors","volume":"148","author":"Hudson","year":"2021","journal-title":"Pediatrics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1097\/RLU.0000000000005389","article-title":"Primary Prostatic Stromal Sarcoma on 18F-PSMA PET\/CT","volume":"49","author":"Chen","year":"2024","journal-title":"Clin. Nucl. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4934","DOI":"10.1016\/j.asjsur.2023.06.008","article-title":"A case report of primary mesenchymal sarcoma of the prostate and the thoughts on its treatment","volume":"46","author":"Yang","year":"2023","journal-title":"Asian J. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1053\/j.seminoncol.2020.10.002","article-title":"Homologous recombination repair deficiency as a therapeutic target in sarcoma","volume":"47","author":"Oza","year":"2020","journal-title":"Semin. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1038\/s41379-021-00818-6","article-title":"Re-evaluating tumors of purported specialized prostatic stromal origin reveals molecular heterogeneity, including non-recurring gene fusions characteristic of uterine and soft tissue sarcoma subtypes","volume":"34","author":"Acosta","year":"2021","journal-title":"Mod. Pathol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1016\/S1470-2045(16)30507-1","article-title":"Safety and efficacy of regorafenib in patients with advanced soft tissue sarcoma (REGOSARC): A randomised, double-blind, placebo-controlled, phase 2 trial","volume":"17","author":"Mir","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13569-016-0064-0","article-title":"Response to anti-PD1 therapy with nivolumab in metastatic sarcomas","volume":"6","author":"Paoluzzi","year":"2016","journal-title":"Clin. Sarcoma Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1056\/NEJMoa1500596","article-title":"PD-1 Blockade in Tumors with Mismatch-Repair Deficiency","volume":"372","author":"Le","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4685","DOI":"10.1158\/1078-0432.CCR-21-0327","article-title":"FDA Approval Summary: Pembrolizumab for the Treatment of Tumor Mutational Burden-High Solid Tumors","volume":"27","author":"Marcus","year":"2021","journal-title":"Clin. Cancer Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"103700","DOI":"10.1016\/j.critrevonc.2022.103700","article-title":"The efficacy of immune checkpoint inhibitors in rare tumors: A systematic review of published clinical trials","volume":"174","author":"Guven","year":"2022","journal-title":"Crit. Rev. Oncol.\/Hematol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4346","DOI":"10.1158\/1078-0432.CCR-22-1432","article-title":"Safety and Efficacy of 90Y-FAPI-46 Radioligand Therapy in Patients with Advanced Sarcoma and Other Cancer Entities","volume":"28","author":"Fendler","year":"2022","journal-title":"Clin. Cancer Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1097\/RLU.0000000000003780","article-title":"Prostate-Specific Membrane Antigen Expression in Metastatic Angiosarcoma Detected on 18F-PMSA PET\/CT: A New Potential Prognostic Marker","volume":"47","author":"Marafi","year":"2022","journal-title":"Clin. Nucl. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"20220886","DOI":"10.1259\/bjr.20220886","article-title":"Prostate-specific membrane antigen (PSMA) as a potential target for molecular imaging and treatment in bone and soft tissue sarcomas","volume":"96","author":"Kleiburg","year":"2023","journal-title":"Br. J. Radiol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/1918\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:37:21Z","timestamp":1760114241000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/1918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,22]]},"references-count":35,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["medicina60121918"],"URL":"https:\/\/doi.org\/10.3390\/medicina60121918","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,22]]}}}