Primary leiomyosarcoma of prostate: Report of 3 cases

Abstract

Prostate sarcomas originate from the mesenchymal tissues including smooth muscle, fibromuscular stroma, paraganglia, nerves, and blood vessels. They account for less than 0.1% of all prostate tumors and often present with obstructive symptoms. Leiomyosarcoma is the most common sarcoma involving the prostate in adults affecting men between the ages of 40 and 78 years. Patients with leiomyosarcoma of the prostate commonly have a poor prognosis and their life expectancy depends on the stage of the disease at the initial diagnosis. Histopathological examination is essential for definitive diagnosis and can be performed at an early stage using guided transrectal prostate biopsy. Since prostate specific antigen (PSA) levels are generally normal, digital rectal examinations are extremely important. Tumor cells commonly express vimentin, smooth muscle actin and desmin, and up to 25% express cytokeratins. We report 3 cases of prostatic leiomyosarcoma with clinical, radiological, histopathological features and immunohistochemistry.