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Background & Objectives: Prostatic Stromal Tumours of Uncertain Malignant Potential (STUMP) are non-epithelial mesenchymal spindlecell origin prostate tumours classified as a specialized stromal tumour of the prostate. They represent rare neoplastic proliferative lesions that according to WHO classification together with prostatic stromal sarcoma (SS) comprise up to 0.2% of all malignant prostate tumours. Methods: We present a case of patient clinically presented with symptoms of acute urinary retention (AUR). Digital rectal examination (DRE) showed the presence of a pronounced prostatic hyperplasia and a transurethral prostatic adenomectomy (TURPA) was performed. The primary pathological evaluation was performed at Laboratorii Uniti, Italy and second opinion at the Department of Pathology, Clinical Hospital Centre Rijeka, Croatia upon an incidental and unexpected diagnosis of prostatic STUMP. It was morphologically discriminated based on following criteria: stromal cellularity, presence of occasional mitotic figures, necrosis, and stromal overgrowth. Thorough immunohistochemistry evaluation and tumour immunophenotyping was performed. Results: Presented tumour was immunohistochemically positive for CD34, Vimentin, progesterone and cytokeratin negative. It diffusely infiltrated the prostate gland and extend into adjacent tissues. Mitotic count was low, while focally marked cellular atypia was observed throughout the lesion. The capacity of recurrence placed it into the group considered to have frank neoplastic capacity. Therefore the clinical and further therapeutic management should be made keeping in mind the probability of progression into sarcoma. Conclusion: Currently, due to a small number of cases and consequent follow up the recommended treatment algorithm does not exist. According to some authors and literature data, radical prostatectomy seem to be the treatment of choice, especially in young patient or for extensive recurrent lesion. The presented case stresses out the need for extensive sampling in order to fully appreciate tumour heterogeneity, because STUMP remains diagnosis by exclusion. |
