不確定惡性程度的攝護腺基質腫瘤以尿路阻塞為表現：個案報告及文獻回顧
林柏翰, 蕭毅君, 薛又仁, 邱文祥
臺北市立聯合醫院仁愛院區 外科部 泌尿科
Prostatic stromal tumor of uncertain malignant potential (STUMP) presenting with urinary obstruction: a case report and literature review
Po-Han Lin., Yi-Chun Hsiao, Thomas Y. Hsueh, Allen W. Chiu
Divisions of Urology, Department of Surgery, Taipei City Hospital Ren-Ai branch, Taipei, Taiwan
Introduction: Prostatic stromal tumor of uncertain malignant potential (STUMP) is a rare neoplastic lesion of specialized stromal cells. The diverse manifestations of STUMPs deserve further investigation for disease management.
Case presentation: We report a case of a 63-year-old man presented with urinary obstruction and bladder stone formation. Urethrocystoscopy revealed a tumor in the prostatic urethra near bladder neck. STUMP of hypercellular spindle cells type was diagnosed by the pathology of the specimen obtained from transurethral resection. After 1 year of follow up, there was no evidence of recurrence on follow-up transrectal ultrasound image.
Discussion: STUMP commonly presented with urinary obstruction, abnormal digital rectal examination or elevated serum prostatic-specific antigen. Few cases of STUMP were associated with metastatic stromal sarcoma in clinicopathology study. Similar profile of chromosomal aberrations between STUMP and stromal sarcoma also suggests they probably represent a spectrum of disease. Concerning its malignant potential, some advocated complete excision. However, in review of literatures, most STUMPs underwent indolent courses and conservative management with close clinical follow-up is reasonable.
Conclusion: The pathogenesis of STUMP and its relationship with stromal sarcoma are yet to be elucidated. Hence, the standard management of STUMP is still controversial and further studies are needed to determine appropriate treatment strategy.