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Recurrent prostatic stromal sarcoma with massive high-grade prostatic intraepithelial neoplasia
  1. Teppei Morikawa1,
  2. Akiteru Goto1,
  3. Kyoichi Tomita2,
  4. Yuzuri Tsurumaki2,
  5. Satoshi Ota1,
  6. Tadaichi Kitamura2,
  7. Masashi Fukayama1
  1. 1Department of Human Pathology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
  2. 2Department of Urology, The University of Tokyo Hospital, Tokyo, Japan
  1. Correspondence to:
 Dr T Morikawa
 Department of Human Pathology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, 113-0033 Tokyo, Japan; tmorikawa-tky{at}


A unique case of prostatic stromal sarcoma (PSS) that recurred in the pelvic cavity with massive high-grade prostatic intraepithelial neoplasia is described. A 52-year-old man who presented with urinary retention underwent a radical cystoprostatectomy. Tumour tissues of the prostate showed an admixture of hyperplastic glands and markedly cellular stroma of spindle cells arranged in a fascicular pattern, and the tumour was diagnosed as PSS. 66 months after the operation, CT scans revealed three recurrent tumours around the bilateral obturator and left fore iliopsoas. The recurrent tumours were biphasic neoplasms, as before, but the epithelial component had grown prominent and manifested overt atypia in a manner resembling high-grade prostatic intraepithelial neoplasia. Our findings suggest that not only the stromal component but also and the epithelial components of PSS may have malignant potential.

  • AMACR, α-methylacyl-coenzyme A racemase
  • HGPIN, high-grade prostatic intraepithelial neoplasia
  • PSA, prostate-specific antigen
  • PSS, prostatic stromal sarcoma

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  • Competing interests: None declared.