Primary and confined gist of the prostate: Case report and review of literature

Abstract

The symptoms of prostate hyperplasia, such as tenesmus, nocturia, and urinary retention are common 
in elderly men. A healthy male patient, 92 years old, in urologic follow up for benign prostatic 
hyperplasia culminated to acute urinary retention and indication of a retropubic prostatectomy. Exams 
documented a prostate of 180 grams, PSA 2.45 ng/dl. A digital rectal exam documented grade IV 
prostate with an adenomatous and fiber elastic aspect, without nodules. Surgery and thorough 
immunohistochemical studies of the specimen were performed, and primary GIST (gastrointestinal 
stromal tumor) of the prostate was confirmed. Posterior staging did not document another focus of the 
illness, and a complete resection of the primary mass was performed. The patient and his family were 
offered all the treatment options and opted for an exclusive clinical follow up, without adjuvant 
chemotherapy or radiotherapy. This decision was made based upon all the collateral effects that 
chemotherapy and radiotherapy would produce with no gain to the patient’s quality of life. In patients 
with localized disease, contingent on individual analysis of performance status as well as social 
aspects, exclusive clinical follow up can be offered according to their life expectancy.