Giant prostatic hyperplasia: case presentation of the second largest prostate adenoma

Abstract

BackgroundBenign prostate hyperplasia is one of the most common diseases in middle-aged or older men. Approximately 50% of men over 60 years old suffer from benign prostatic hyperplasia. Giant prostatic hyperplasia is defined as a prostate exceeding 500 g. In all the literature, ten case reports were published with giant prostatic hyperplasia.Case presentationIn this case report, we present a 72-year-old man with edema of lower extremities. In physical examination, bilateral pitting edema of the lower extremities was detected. Serum prostate-specific antigen level was > 100.00 ng/ml. He did not have lower urinary tract symptoms. International Prostate Symptom Score (IPSS) and uroflowmetry results proved that the patient did not have lower urinary tract symptoms. Radiologic imaging revealed a huge pelvic mass behind bladder. Grade 1 hydronephrosis in the right kidney was detected, but serum creatinine value was normal. This mass was excised with open surgery. This mass was measured 1090 g, and histopathologic examination showed benign prostatic hyperplasia. The patient had no complication at the 12-month follow-up. After 5 years, prostate volume was calculated approximately 108 cc by computer tomography but still the patient did not have any lower urinary tract symptoms.ConclusionIt is important to approach the retroperitoneal mass. Clinicians usually think about malignity, but sometimes that mass can be relevant with benign process. Intra-operative biopsy can help clinicians for both diagnosis and surgical approach. In this case presentation, we report a patient with one of the largest sizes of prostate gland that measured 1090 g.