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-(A) A transabdominal ultrasound examination of the pelvis revealing the approximate contour of the prostate, measuring 5.58 × 5.69 × 5.59 cm, corresponding to a size of 93 mL. The prostate shows heterogeneous echotexture with multiple medium to large cystic components ( arrows ). The indwelling catheter balloon is noted within the bladder. (B) Color flow Doppler of the prostate and surrounding cystic lesion showing no blood flow in them consistent with being cystic in nature.
Source publication
Giant multilocular cystadenomas of the prostate or seminal vesicles are rarely reported in literature. We present a case of a 76-year-old male presenting with lower urinary tract symptoms initially perceived as symptoms of benign prostatic hyperplasia. The patient was investigated by employing a multimodality imaging approach of the prostate that i...
Context in source publication
Context 1
... transabdominal ultrasound of the abdomen and pelvis with color flow Doppler was performed as the initial line of investigation. A large prostate was noted measuring approximately 92 mL, with heterogeneous architecture and multiple small to large cystic lesions, with absent flow on Doppler ( Fig. 1 ). Consequently, in order to delineate the pelvic mass, an enhanced Computed Tomography (CT) scan of the abdomen and pelvis was attained demonstrating a large multiloculated mass arising from the prostate gland and measuring around 12 × 6.7 × 5.2 cm ( Fig. 2 ). ...
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Citations
... T2-weighted and diffusion-weighted imaging may provide additional information on the presence and the nature of any GMPC soft tissue components [4]. Being aware of radiological features of GMPC, alongside other pelvic masses or congenital anomalies of the genitourinary tract, is of considerable clinical relevance given the increasing use of MRI for diagnosis, local staging and follow-up imaging of PCa, which may lead to a more frequent incidental detection of this rare condition [5,6]. Additionally, to our knowledge, the concomitant diagnosis of GMPC and biopsy-proven PCa demonstrated in this report has not been presented previously. ...
Giant multilocular prostatic cystadenoma (GMPC) is a rare benign pelvic mass for which complete surgical resection is an accepted treatment of choice. This report presents the first case of complete resolution of GMPC following a 3-year course of luteinising hormone-releasing hormone agonist alongside external beam radiotherapy for the concurrent treatment of unfavorable intermediate-risk prostate cancer. In addition to illustrating the imaging features of the effect of androgen deprivation therapy (ADT) and radiotherapy on GMPC regression, this case provides evidence for considering ADT as an alternative, noninvasive GMPC treatment option in patients in whom surgical treatment is either contraindicated or can be made less invasive by reducing the size of GMPC prior to its removal.
... Cystadenoma or giant multilocular cystadenoma is a rare (~ 30 cases reported), cystic benign tumor of the prostate [80]. They are reported at any age ranging from 23 to 80 years (mean age 47 years) [81,82]. Most common presentation is urinary obstruction owing to the large size of the tumor often averaging 14 cm; but mass up to 45 cm has been reported [83]. ...
... It can also visualize the pedicle attached to the prostate, determining the organ of origin. On rare occasion, cystadenoma may also arise from seminal vesicles [81]. Tumor is characterized by small as well as large cysts with layering due to hemorrhagic or proteinaceous fluid [80,81] (Fig. 13a). ...
... On rare occasion, cystadenoma may also arise from seminal vesicles [81]. Tumor is characterized by small as well as large cysts with layering due to hemorrhagic or proteinaceous fluid [80,81] (Fig. 13a). Adjacent solid component is usually isointense to the parenchyma showing post-contrast enhancement [6] (Fig. 13b). ...
The purpose of this article is to review the spectrum of rare non-epithelial tumors of the prostate. This focused article will help the readers to understand the imaging findings of such rare entities attributed to their clinicopathological features. Radiologists must be familiar with the spectrum of non-epithelial tumors of the prostate, which helps to suggest alternate diagnosis other than adenocarcinoma, when imaging features are atypical. This is important because these tumors have different management approaches and prognoses when compared to adenocarcinoma of the prostate.
... It is characterized by significantly enlarged prostatic cystadenoma, most of them are larger than 10 cm in size (about 68% in the literature). [2][3][4][5][6][7][8][9][10][11][12][13][14][15] In this condition, the tumor always originates from the prostate and extends to the space between the rectum and bladder, sometimes it may attach to the prostate with pedicle www.md-journal.com or even be completely separated from it. ...
... It often manifests as lower abdominal masses or progressive dysuria, sometimes present with frequent urination. [7] Radical excision is recommended for this condition. Patients will have an excellent prognosis and recurrence is rare if the tumor is totally removed. ...
... This case is consistent with previous reports. [2,7,9] No atypical cell proliferation or mitosis was recognized. Immunohistochemical analysis showed the tumor cells were positive for PSA and PSAP staining, indicating a prostatic origin. ...
Rationale:
Giant multilocular prostatic cystadenoma (GMPC) is a rare type of prostatic epithelial neoplasm. Thus, the imaging features of this condition are not well known. We report the imaging and clinical manifestations of a case of GMPC.
Patient concerns:
The case reported here relates to a 71-year-old man who complained of urination frequency and excessive urination at night. He underwent computed tomography (CT) and magnetic resonance imaging (MRI) examination before surgery, both tests revealed a mass body in the prostate.
Diagnosis:
Ultrasound-guided fine needle aspiration was performed and a diagnosis of GMPC was made by histological examination.
Interventions:
The patient received radical pelvic tumor resection successfully.
Outcomes:
Two months after surgery, the follow-up CT and magnetic MRI re-examination found no signs of recurrence.
Lessons:
GMPC is a rare prostatic neoplasm with atypical clinical symptoms. MRI provides valuable information about GMPC. In case of a giant multilocular prostatic mass with well-defined boundary and abundant vascularity, benign feature on diffusion-weighted imaging, GMPC should be considered.
... So far, there are still no more than 30 cases reported, according to our latest review [3] . It can occur at any age; the age of patients ranges from 23 [4] to 80 years [5] . The tumors are characterized as multiple loculated cysts that vary in size and morphology, usually presenting with obstructive urinary or lower intestinal tract symptoms rather than other complaints, and the prostate-specific antigen (PSA) level may or not be high. ...
Background:
Giant multilocular cystadenoma (GMC) of the prostate gland is a very rare benign tumor. Although the benign nature has been known, complete surgical excision is the major treatment consensus because of its high recurrence rate. We report a rare case of GMC with accompanying lower urinary tract symptoms and repeated urine retention initially thought to be symptoms of benign prostatic hyperplasia, which was treated with robot-assisted laparoscopic radical prostatectomy.
Case summary:
A 65-year-old man presented with a 2-year history of lower urinary tract symptoms that had deteriorated gradually within the previous six months, even though he had received treatment with a selective alpha-blocking agent. He had undergone two transurethral resections of the prostate (TURP) at a local hospital during a 4-mo interval because initial ultrasound imaging and prostatic core needle biopsy showed benign prostate hyperplasia. Upon the third recurrence, the patient underwent TURP with a green-light laser at our institution. The diagnosis was a tumor composed of variously sized dilated glandular and cystic structures lined by blended prostatic type epithelia positive for prostate-specific antigen; the final diagnosis was giant multilocular cystadenoma. Magnetic resonance imaging showed a large multilocular retrovesical mass 8.0 cm × 7.3 cm × 6.4 cm, with heterogeneous enhancement. A coexisting malignant part could not be excluded. Considering the high recurrence rate, risk of coexisting malignancy, and possible sequelae of open surgery for radical excision, the patient decided to undergo robot-assisted radical prostatectomy, with good outcomes at the 2-year follow-up.
Conclusion:
Robot-assisted surgery for the treatment of prostate GMC provides another choice for simultaneous attention to disease-control and postoperative quality of life.
... Thus, the differential diagnoses include other prostatic cystic lesions such as cystic change of benign prostatic hyperplasia, prostatic retention cysts, müllerian cysts, and prostatic abscess [7]. Besides, some retroperitoneal cystic lesions such as lymphangioma and prostatic sarcoma should also be considered [8]. In addition, seminal vesicle cystadenoma also needs to be taken into consideration before the source of the mass is determined. ...
... PSA elevation has been reported in several cases [3][4][5][8][9][10][11], the highest of which was 68.2 ng/mL [9]. In our case, the PSA level was 17 ng/ml. ...
Giant multilocular prostatic cystadenoma is a rare benign tumor that originates from the prostate gland. It usually is between the rectum and the bladder, and is composed of predominantly cystic enlarged prostatic glands in a fibrous stroma and spreads extensively in the pelvis. The mass usually causes a series of obstructive symptoms by compressing adjacent organs. Here we report a case of a giant multilocular prostatic cystadenoma in a 16-year-old patient, who is the youngest case reported up to now, complaining of difficulty in defecation.
