Leyla MEMİŞ, İlker ŞEN, Hasan BİRİ, İbrahim BOZKIRLI, Metin ONARAN, Lütfi TUNÇ, Güldal YILMAZ

Rektal invazyonla seyreden erişkin agresif prostat rabdomiyosarkomu

Embriyonal prostat sarkomları erişkin primer prostat kanserlerinin %0.1’den azını oluşturmaktadır. Hastalar genellikle obstrüktif idrar yapma ve rektal basılanma semptoları ile başvururlar. Agresif bir tümördür ve bir çok hasta prognozu kötüleştiren ileri evre ve metastatik lezyonlar ile başvurur. Çalışmamızda rektal perforasyon nedeniyle lokal kontrolü sağlamak için pelvik ekzantrasyon yapılan bir prostat embriyonal rabdomyosarkomu olgusu sunulmuştur. Ayrıca ciddi rektal kanamanın neden olduğu akut kan kaybı da radikal cerrahi seçiminde etkili olmuştur. Her klinisyen, nadir görülen ve mümkün olduğunca metastatik olmadan, doğru tanı konması gereken bu hastalıkla ilgili sunduğumuz klinik belirtileri ayırıcı tanıda akılda tutmalıdır.

An aggressive adult prostate rhabdomyosarcoma with rectal invasion

Embryonal prostate sarcomas constitute less than 0.1% of primary prostate cancer cases in adults. Patients usually present with obstructive voiding and rectal compression symptoms. Due to the unusual aggressive behaviour of this disease, most patients presenting with advanced stage and metastatic lesions will have a poor prognosis. We report a patient with rectal perforation in which pelvic exenteration was performed in order to reach negative surgical margins. In addition, severe rectal bleeding leading to acute blood loss supported the indication to perform this radical surgery in our case. Thus, every physician should keep this rare disease in mind during the differential diagnosis of a patient sharing clinical features with our case to reach an exact diagnosis as soon as possible before metastatic disease develops.

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