Primary Leiomyosarcoma of the Prostate Gland: A Review and Update
PLSOP (primary leiomyosarcoma of the prostate) is a rare cancer, with just about 200 cases identified to date. PLSOPs are characterised by lower urinary tract symptoms, haematuria, and perineal pain; they may or may not be linked to a history of prior radiotherapy and/or hormone treatment for adenocarcinoma of the prostate; they may affect both children and adults. A benign enlarged prostate and a hard enlarged mass can be discovered during an examination. Histological inspection of prostate specimens reveals spindle-shaped carcinoma cells, which can be used to diagnose PLSOPs. Vimentin, CD44, smooth muscle actin, and calponin immunohistochemistry appears to be positive, with desmin and keratin staining being focally positive. PSA, S-100, CD34, CD117, and cytokeratin are all negative. Cytogenetic analysis of primary prostate gland leiomyosarcoma may reveal clonal chromosomal rearrangement on Chromosomes 2, 3, 9, 11, and 19. Overall, the prognosis is bleak. For operable PLSOPs, surgery with or without chemotherapy tends to be the mainstay of treatment, but there is no universal consensus about the best therapeutic approach. The majority of PLSOPs cases are found after the disease has progressed to an advanced stage. To find therapies that would enhance the prognosis, a global multi-center trial is needed. Cryotherapy plus multi-modality adjuvant therapy, radiofrequency ablation of the tumour plus multi-modality adjuvant therapy, selective prostatic artery angiography and super-selective embolization of the arterial branch supplying the tumour plus multi-modality adjuvant therapy, and immunotherapy plus multi-modality adjuvant therapy are all new treatment options that need to be investigated.
Author (s) Details
Anthony Kodzo-Grey Venyo
Department of Urology, North Manchester General Hospital, Delaunays Road, Manchester, United Kingdom.
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