Prostate Sarcoma – A Diagnostic Challenge Initially Suspected as Prostatitis

Abstract

Prostatic sarcoma can mimic benign urological disease and delay diagnosis. A 42-year-old man presented with urinary symptoms and pelvic pain and was initially treated for suspected prostatitis. CT and multiparametric MRI demonstrated an extensive prostatic mass with adjacent-organ invasion and obstructive uropathy. Histopathological evaluation subsequently established a partially CD34-positive sarcoma without further classification; staging revealed hepatic metastases. Doxorubicin and ifosfamide produced an initial partial response, followed by pelvic exenteration. Local recurrence and metastatic progression subsequently occurred despite gemcitabine/docetaxel and pazopanib. The patient died in June 2023. This case highlights the diagnostic value of imaging and tissue assessment in atypical or persistent urological presentations and the aggressive clinical course that may occur despite multidisciplinary treatment.