Ibrahimi Ahmed, Mikou Mohamed Ali, Boualaoui Imad, Ouskri Salim, Iraqui Imane, El Abidi Hamza
Urology A Departement, University Hospital ibn Sina, Rabat, Morocco.
Urology A Departement, University Hospital ibn Sina, Rabat, Morocco.
Int J Surg Case Rep. 2025 Sep;134:111769. doi: 10.1016/j.ijscr.2025.111769. Epub 2025 Aug 12.
Ewing sarcoma (ES) is a rare and aggressive neoplasm that primarily affects bones and soft tissues, with extraosseous manifestations extremely rare, making it difficult to diagnose and treat these localizations.
A 32-year-old male experienced chronic pelvic pain and urinary symptoms due to a large prostatic ES (174 × 123 × 181 mm), resulting in acute renal failure. Despite normal PSA levels (1.5 ng/mL), imaging showed extensive local invasion. Histopathological examination revealed ES via CD99 positivity and molecular EWSR1 rearrangements. Palliative chemotherapy (VAC regimen) was given due to unresectability, but the patient died within eight months from disease progression.
This case highlights the diagnostic challenges, essentially caused by non-specific symptoms and normal PSA levels, emphasizing the importance of immunohistochemical analysis for the confirmation. A review of the literature reveals that prostatic ES frequently presents in advanced stages, necessitating multimodal treatment. However, survival rates remain low despite the use of aggressive treatment.
Prostate Ewing sarcoma is a formidable malignancy that must be detected early and treated aggressively. Increased clinician awareness and additional research into targeted therapies are critical for improving outcomes in this rare but aggressive disease.
尤因肉瘤（ES）是一种罕见的侵袭性肿瘤，主要累及骨骼和软组织，骨外表现极为罕见，这使得这些部位的诊断和治疗变得困难。
一名32岁男性因巨大的前列腺尤因肉瘤（174×123×181mm）出现慢性盆腔疼痛和泌尿系统症状，导致急性肾衰竭。尽管前列腺特异性抗原（PSA）水平正常（1.5ng/mL），但影像学检查显示有广泛的局部侵犯。组织病理学检查通过CD99阳性和分子EWSR1重排确诊为尤因肉瘤。由于无法切除，给予了姑息化疗（VAC方案），但患者在八个月内死于疾病进展。
该病例突出了诊断方面的挑战，主要是由非特异性症状和正常的PSA水平引起的，强调了免疫组化分析在确诊中的重要性。文献回顾显示，前列腺尤因肉瘤常处于晚期，需要多模式治疗。然而，尽管采用了积极的治疗方法，生存率仍然很低。
前列腺尤因肉瘤是一种严重的恶性肿瘤，必须早期发现并积极治疗。提高临床医生的认识以及对靶向治疗进行更多研究对于改善这种罕见但侵袭性疾病的治疗效果至关重要。
