Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan.
Yale J Biol Med. 2021 Dec 29;94(4):609-612. eCollection 2021 Dec.
: Schwannoma of the male genital system is very uncommon and is mostly treated by surgery. However, prostatic schwannoma presenting with elevated prostate-specific antigen (PSA) level and treated conservatively are extremely rare. : Herein, we present a rare case of a prostatic schwannoma in a 65-year-old man who initially presented with an elevated PSA level. Digital rectal examination revealed an enlarged prostate with a palpable hard nodule on the left side. Transrectal ultrasonography revealed an enlarged prostate with a well-defined homogeneously hypoechoic nodule in the left peripheral lobe. Biopsy was done, and histopathology revealed a prostatic schwannoma. Conservative treatment with regular image follow-up was done per the patient's preference. Mild PSA progression but no worsening of symptoms was found in 6 years of follow-up. : PSA elevation could be a rare presentation of prostatic schwannoma. Treatment options other than surgery, such as conservative treatment with close observation, could be feasible for these rare tumors and long-term survivorship can be achieved.
男性生殖系统神经鞘瘤非常罕见,主要通过手术治疗。然而,表现为前列腺特异性抗原(PSA)水平升高并接受保守治疗的前列腺神经鞘瘤极为罕见。
在此,我们报告一例 65 岁男性前列腺神经鞘瘤的罕见病例,该患者最初表现为 PSA 水平升高。直肠指检发现前列腺增大,左侧可触及硬结节。经直肠超声显示前列腺增大,左侧外周叶有界限清楚的均质低回声结节。行活检,组织病理学显示为前列腺神经鞘瘤。根据患者的意愿,采用定期影像学随访的保守治疗。6 年的随访发现 PSA 轻度进展,但症状无恶化。
PSA 升高可能是前列腺神经鞘瘤的罕见表现。对于这些罕见肿瘤,除手术外,还可以选择其他治疗方法,如密切观察的保守治疗,长期生存是可以实现的。