Korean J Radiol.  2011 Aug;12(4):519-523. 10.3348/kjr.2011.12.4.519.

MRI Appearance of Prostatic Stromal Sarcoma in a Young Adult

• Tamada T
• Sone T
• Miyaji Y
• Kozuka Y
• Ito K

• KMID: 1783221
• DOI: http://doi.org/10.3348/kjr.2011.12.4.519

Abstract

Prostatic stromal sarcoma (PSS) is quite rare. Herein, we describe magnetic resonance imaging (MRI) features of a PSS identified in a 26-year-old man with dysuria and hematuria. MRI clearly depicted the extent and multinodular appearance of the tumor, which was mainly located in the central zone of the prostate. The tumor appeared as a heterogeneously signal-hyperintense mass with a pseudocapsule on T2-weighted imaging. Contrast-enhanced T1-weighted MRI showed necrotic portions in the gradually enhanced solid mass, and diffusion-weighted imaging permitted the accurate assessment of the local extent of the tumor. Thus, the appearance on MRI was quite different from that of adenocarcinoma of the prostate.

Keyword

Prostatic stromal sarcoma; Prostatic neoplasms; Magnetic resonance (MR); Diffusion magnetic resonance imaging; T2-weighted imaging, dynamic contrast-enhanced MRI

MeSH Terms

Adult
Contrast Media/diagnostic use
Diagnosis, Differential
Fatal Outcome
Gadolinium DTPA/diagnostic use
Humans
Magnetic Resonance Imaging/*methods
Male
Prostatic Neoplasms/*diagnosis
Stromal Cells/*pathology

Figure

• 

  Fig. 1 Prostatic stromal sarcoma in 26-year-old man. A. Axial T1-weighted image showing mass located centrally and to right side of prostate with homogeneous slight low signal intensity in comparison with left side of prostate (arrows). B. Axial T2-weighted echo-planar image showing multinodular mass (arrows) with irregular margins associated with nodular lesions (small arrows) in posterior part of mass, and presenting heterogeneous high signal intensity. Right peripheral gland (arrowheads) is compressed by central glandular mass. C-E. Axial dynamic contrast-enhanced MR images at 0 s (C), 30 s (D) and 150 s (E) after contrast injection, showing weakly enhanced mass containing non-enhanced cystic areas in central gland (arrows). As right peripheral gland shows gradual moderate enhancement (arrowheads), which differs from enhancement in left peripheral gland, tumor invasion to right peripheral gland is suggested. F. Axial diffusion-weighted image showing central gland mass (arrows) and right peripheral zone mass (arrowheads) as areas of marked high signal intensity. G. Coronal T2-weighted image showing markedly enlarged lymph nodes near seminal vesicle and separated from prostatic mass (arrow). H. Histological findings from transurethral resection of prostate. Low-power views show leaf-like projection of proliferating stroma. Cellular stroma contains round and spindle-shaped cells with atypia and mitosis (Hematoxylin & Eosin staining, × 100).

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