Tumor Mesenkim Prostat Pada Pasien Dewasa Muda : Laporan Kasus : Prostate Mesenchymal Tumors in Young Adult Patients

Wira Amaz  Gahari; Aristo Aristo

doi:10.52103/jahr.v6i1.1909

Authors

Wira Amaz Gahari Dokter Umum, Rumah Sakit Umum Daerah Undata, Palu,Sulawesi Tengah, Indonesia
Aristo Aristo Urolog, Depertemen Bedah, Fakultas Kedokteran Universitas Tadulako, Palu,Sulawesi Tengah, Indonesia; Urolog, Depertemen Bedah, Rumah Sakit Umum Daerah Undata, Palu, Sulawesi Tengah, Indonesia

DOI:

https://doi.org/10.52103/jahr.v6i1.1909

Keywords:

Prostat, Malignansi, PSS, STUMP

Abstract

Abstrak

Neoplasma pada jaringan mesenkim hanya sekitar 0,1% dari total tumor yang terjadi pada prostat dan berpotensi menjadi malignansi. Sarkoma stroma prostat (PSS) sebagian besar memiliki prognosis yang buruk, sekitar 50% akan meninggal dalam waktu 2 tahun atau bahkan lebih singkat. Di sini, kami melaporkan seorang pria berusia 46 tahun yang datang dengan LUTS dan berkembang menjadi retensi urin dalam 2 minggu. Hasil pemeriksaan tidak menunjukkan adanya keganasan. Pemeriksaan colok dubur (DRE) menunjukkan pembesaran prostat dengan konsistensi lunak dan permukaan yang teratur. Pemeriksaan ultrasonografi transabdominal menunjukkan struktur ekostruktur prostat yang homogen dengan volume 80ml3, dan prostate specific antigen (PSA) total adalah 0,57 ng/mL. Pasien kemudian menjalani transurethral resection prostate (TURP), hasil interpretasi histopatologi menunjukkan tumor mesenkim prostat. Tumor ini dibagi menjadi Stromal Tumor of Uncertain Malignant Potential (STUMP) dan PSS, yang seharusnya umum terjadi pada usia dekade ke-7. Penemuan tumor mesenkim pada pasien ini secara insidentil dari jaringan reseksi prostat. Setelah itu, CT-Scan abdomen dengan kontras dilakukan untuk menentukan kemungkinan adanya metastasis. Pasien disarankan untuk memantau pertumbuhan dan penyebaran tumor. Tumor mesenkim masih merupakan kasus yang jarang ditemukan, karena sedikitnya jumlah kasus serupa yang dilaporkan akibat ukuran jaringan yang sangat kecil, kesulitan dalam membedakan neoplasma stroma, dan terbatasnya keahlian ahli patologi dalam menginterpretasi, sehingga diperlukan lebih banyak case series untuk mempertimbangkan terapi standar.

Abstract

Neoplasm in the mesenchymal tissue is only about 0.1% of the total tumors that occur in the prostate and potent to be malignant. Prostate stromal sarcoma (PSS) mostly have poor prognosis, about 50% will die within 2 years or even shorter. Here, we report a 46-years old male presented with LUTS and progressed to be urinary retention in 2 weeks. The examination results did not suggest malignancy. Digital rectal examination (DRE) showed an enlarged prostate with soft consistency and regular surface. Transabdominal ultrasonography examination showed homogeneous prostate echostructure with a volume of 80ml3, and total prostate spesific antigen (PSA) is 0.57 ng/mL. The patient then underwent transurethral resection of postate (TURP), apparently the histopathologic interpretation showed a prostate mesenchymal tumor. These tumors are divided into Stromal Tumor of Uncertain Malignant Potential (STUMP) and PSS, which should be common in 7th decade. The patient was found to have a mesenchymal tumor incidentally from prostate resection tissue. After that, an abdominal CT-Scan with contrast was performed to determine the possibility of metastasis. The patient was adviced to monitor the growth and spread of the tumor. Mesenchymal tumors are still a rare case, because the small number of similar cases reported due to very small tissues size, difficulty in distinguishing stromal neoplasms, and limited expertise of pathologists in interpreting, so we need more cases series to consider the standard therapy.

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