Prostate spindle cell sarcoma is a type of prostate sarcoma, which is a highly malignant and aggressive malignant tumor of the prostate.
The main types of prostate sarcomas are rhabdomyosarcoma, smooth muscle sarcoma, spindle cell sarcoma, hemangiosarcoma, and chondrosarcoma, the most common being rhabdomyosarcoma. Prostate spindle cell sarcoma is extremely rare and mainly originates from the specialized mesenchyme of the prostate. Spindle cell sarcomas are common in young men, with more than 50% of patients being younger than 50 years of age.
The clinical manifestations of spindle cell sarcoma of the prostate are mostly acute urinary retention that progresses rapidly, with some patients experiencing urinary frequency, urgency, hematuria, and hematochezia. Serum free PSA is low because prostatic spindle cell sarcoma originates in the prostatic mesenchyme. However, abnormal mass is usually palpable on rectal examination.
Therefore, if there is a young patient with acute urinary retention and a palpable mass on rectal examination, even if the serum free PSA is not high, a multiparameter MRI of the prostate should be performed.
Prostate multi-parameter MRI can initially determine the nature of the prostate mass, showing the relationship between the prostate mass and the surrounding tissue structure. At present, the gold standard for the diagnosis of prostate spindle cell sarcoma is still prostate puncture biopsy.
The degree of malignancy of prostate spindle cell sarcoma is high, prostate spindle cell sarcoma is more aggressive, most patients have already had local infiltration or distant metastasis at the time of diagnosis, and the prognosis is often poor. Prostate spindle cell sarcoma is extremely insensitive to radiotherapy, chemotherapy and conventional endocrine therapy, radical surgical resection is currently the preferred treatment option.