高雄榮民總醫院 外科部 泌尿外科 移植外科
Robot-assisted tumor excision with partial prostatectomy for prostatic cystadenoma with high serum PSA level, a case report and literature review.
Chih-Jen Wang, Chia-Cheng Yu
Division of Urology and Transplant Surgery, Department of Surgery,
Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Prostatic cystadenoma is a rare benign neoplasm, which may also result in high serum PSA level and voiding symptoms.
A 61-year-old male presented to our emergent department with acute urinary retention, perineal pain, and difficulty in defecation recently. Digital rectal examination disclosed a soft mass at left side.
Bedside ultrasonography revealed a cystic mass at the prostate. Elevated serum prostate-specific antigen levels of 211.3 ng/ml was noted. Magnetic resonance imaging of the pelvis showed a large, multilocular, and well-capsulated cystic lesion, about 12 x 10 x 9 cm3 in size, at the left posterolateral aspect of the prostate. Robot-assisted excision of tumor with seminal vesicle and partial prostatectomy were performed for treatment. The pathology report revealed prostatic cystadenoma. After surgery, the patient could urinate smoothly, and the PSA level dropped to 2.2 ng/ml three month later.
Complete resection could be curative by robotic approach. Preoperative MRI can provide information for diagnosis. We also reviewed the literature.