# High-grade prostatic stromal sarcoma with a distinctive cystic-solid MRI pattern and aggressive clinical course: a case report

## TL;DR

This case report describes a rare aggressive prostate tumor with unique MRI features that can help in early diagnosis.

## Contribution

The paper highlights the distinctive MRI pattern of high-grade prostatic stromal sarcoma to improve diagnostic accuracy.

## Key findings

- MRI showed a large cystic-solid mass with restricted diffusion in the solid components.
- The tumor involved the seminal vesicle and had positive surgical margins confirmed by histopathology.
- The patient experienced local recurrence within six months despite chemotherapy.

## Abstract

To report a rare case of high-grade prostatic stromal sarcoma (PSS) and delineate its characteristic magnetic resonance imaging (MRI) features to facilitate early detection and accurate diagnosis.

A 55-year-old male presented with progressive dysuria. Preoperative multiparametric pelvic MRI was performed. The imaging findings were correlated with histopathology from a robot-assisted laparoscopic radical prostatectomy.

MRI revealed a large, well-demarcated, encapsulated cystic-solid mass within the prostate. The solid components showed restricted diffusion. The cystic component contained multiple septations and demonstrated no diffusion restriction. An involvement nodule was identified in the right seminal vesicle. Histopathology confirmed high-grade prostatic stromal sarcoma with positive surgical margins. The patient experienced local recurrence within six months despite adjuvant chemotherapy.

Prostatic stromal sarcoma is a rare malignancy with distinct MRI features that can help differentiate it from more common prostatic neoplasms.