Table 1 Cases of giant multilocular prostatic cystadenoma
Reference | Year | No. of cases | Age (years) | Clinical symptoms | PSA (ng/ml) | Biopsy | Radiologic findings | Size (cm) | Volume (g) | Contents | Treatment | Folllow-up | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Watanabe et al. | 1990 | 1 | 80 | urinary retention | 8.2 | connective tissue | large tumor in the pelvic cavity | 11 × 8 × 7 | 660 | cloudy fluid similar to semen | anterior pelvic exenteration | 2 years | no recurrence |
Maluf et al. | 1991 | 2 | 28 | Urinary retention | NA | Fragments of prostatic tissue | NA | 19 × 16 × 7 | 600 | Brown fluid and others with gray color | Surgical excision | 4 months | No recurrence |
38 | Increasing abdominal girth, difficulty in micturition | NA | NA | NA | 45 × 35 × 13 | 6500 | Serous, serosanguinous, or mucinous fluid | Resection → exenteration and pelvic irradiation | 2 years | No recurrence | |||
Lim et al. | 1993 | 1 | 64 | Lower abdominal pain, obstructive voiding symptoms | NA | NA | Fluid-filled mass | 17 × 13 × 7 | NA | NA | En bloc excision | NA | NA |
Levy et al. | 1993 | 1 | 56 | Decreased force of urinary stream, hesitancy and frequency of urination | NA | Negative for malignant cells (cytology) | Multi-septated pelvic mass with thickened irregular walls | 13 × 10 × 7 | NA | Yellowish-brown fluid | Complete surgical excision | 8 years | No recurrence |
Morimoto et al. | 1994 | 1 | 45 | Urinary retention | 6 | Benign prostatic tissue | A mass with multilocular structure at the position of the prostate | 5.5 × 5 × 5 | 210 | Yellow fluid | Surgical resection | 9 months | No recurrence |
Kirsch et al. | 1996 | 1 | 65 | Hemorrhoidal pain, obstructive voiding symptoms, gross hematuria | 30.2 | No evidence of malignancy (cystic component) | Heterogeneous mass arising from the prostate and extending to the level of the sacral promontory | 15 × 12.5 × 3 | 130 | Straw-colored fluid | Full enucleation | 1 year | No recurrence |
Choi et al. | 2000 | 1 | 57 | Lower abdominal mass and dysuria | NA | NA | Large multiseptated pelvic mass with thickened irregular walls | 15 × 10 × 8 | 300 | Brown, rusty appearing fluid, transparent serous fluid | Surgical resection | NA | NA |
Seong et al. | 2002 | 1 | 48 | Gross hematuria and frequency | 68.2 | Chronic inflammatory lesion | Oval, low-attenuated mass between the bladder and rectum, containing cystic and solid portions | 8 × 7.5 × 6 | 180 | Reddish-brown serous fluid | Excision with bilateral seminal vesicles and vas deferens | NA | No recurrence |
Matsumoto et al. | 2002 | 1 | 35 | Gross hematuria | 14.4 | NA (abandoned) | Multilocular mass replacing the prostatic gland | 9 × 8 × 6 | 860 | Reddish-brown serous fluid | Radical cystoprostatectomy | 24 months | No recurrence |
Rusch et al. | 2002 | 2 | 30 | Urinary retention, lower urinary tract symptoms | NA | Benign prostatic tissue with cystic dilatation of glands and no evidence of malignancy | Multiple septations with some soft-tissue components | 15 | NA | Hemorrhagic fluid | Surgical resection | 18 months | No recurrence |
41 | Urinary retention (recurrence) | NA | NA | Multiseptated cystic mass | 15 | NA | NA | Surgical excision | NA | NA | |||
Datta et al. | 2003 | 1 | 71 | Urinary retention | NA | NA | Cystic pelvic mass | 12 × 7 × 4.5 | NA | NA | Cystoprostatectomy and removal of a portion of the rectum, GnRH antagonist | 11 years | Recurrence and hormonal therapy |
Allen et al. | 2003 | 1 | 52 | Lower urinary tract symptoms, gross hematuria | 3 | NA | Multiloculated cystic pelvic mass | 14 × 10 × 1 | NA | NA | Completely removed piecemeal with the largest tissue fragment | NA | NA |
Ganesan et al. | 2006 | 1 | 28 | Reduced force of the urinary stream and hesitancy and frequency of urination | 1.6 | Cystic lesion lined by columnar epithelium with cystic dilatation of prostatic acini | Cystic mass with multiple thin, echogenic internal septations (transabdominal ultrasound) | 9.9 × 8.5 × 7.3 | NA | Straw-colored fluid | Debulking | NA | NA |
Tuziak et al. | 2007 | 2 | 42 | Obstructive urinary symptoms, urinary retention | 0.04 | Fibrous tissue interspersed with prostatic glands having no atypical features | Multicystic pelvic mass | 15 | NA | NA | Open prostatectomy without seminal vesicle removal | 2 years | No recurrence |
Park et al. | 2007 | 1 | 61 | Abdominal distension, urinary retention, aspermia | 38.2 | NA | Mass located between the rectum and bladder | 9 × 7 | NA | NA | Mass excision | 1 year | No recurrence |
Chowdhury et al. | 2009 | 1 | 35 | Left loin pain, hematuria, micturition | NA | NA | Complex septated cystic/soft tissue mass | 20 × 11 × 15 | NA | NA | Debulking | NA | NA |
Lee et al. | 2010 | 1 | 71 | Urinary tract obstruction | NA | NA | Multilocular heterogenous cystic pelvic mass posterior to the bladder and anterior to the rectum | 10 × 6.5 × 5.5 | NA | Dark brown hemorrhagic fluid | Radical cystoprostatectomy | 1 year | No recurrence |
Olgun et al. | 2012 | 1 | 23 | Obstructive voiding symptom, difficulty in defecation | 20.2 | Only red blood cells and histiocytes with groups of benign epithelial cells | Multiseptated, huge cystic lesion that filled the pelvis completely | 7 × 5 × 2.5 solid mass, 9 × 9 × 0.2 cystic component | NA | Serous and mucinous fluids | Debulking of the mass | 18 months | No recurrence |
Baad et al. | 2015 | 1 | 55 | Acute urinary retention, gross hematuria, lower abdominal pain | 9.8 | Benign prostatic tissue | Mutilocular, retrovesicular midline mass with multiple thin septations | 11 × 9 × 7 | NA | Straw-colored fluid | Partial prostatectomy with enucleation of the mass | NA | NA |
Rahman et al. | 2016 | 1 | 74 | Hypogastric pain, constipation, obstructive voiding symptom | 20.5 | Benign prostatic tissue | Multiloculated cystic pelvic mass, peripheral contrast enhancement | 11.6 × 9 × 8 | NA | Dense brown liquid | Laparoscopic | 48 months | No recurrence |
Our case | 2018 | 1 | 50 | Abdominal distension, lower urinary symptom | NA | Spindle cell tumor with focal smooth muscle differentiation | Multiloculated cystic mass | 32 × 23 × 10 | 3000 | Blackish-brown fluid | Surgical resection | 6 months | No recurrence |