Not What It Seemed: The Hidden Mass Behind the Bladder Illusion Huge Prostatic Sarcoma

Abstract

Aim: To report an extremely rare case of huge prostatic sarcoma, to best of our knowledge it is the largest to be reported in India. Presentation of Case: Prostate sarcoma is extremely rare, comprising <0.1% of prostate cancers. A 51-year male presented with acute urinary retention. Imaging following decompression revealed a massive prostatic tumor measuring ~1130 cm³, with evidence of bilateral ureteric obstruction, local invasion into the rectal mesocolon & lateral pelvic wall. Transrectal Ultrasound (TRUS) biopsy suggested Prostatic Sarcoma. Anterior pelvic exenteration with ileal conduit with end colostomy was planned; however, the patient succumbed to cardiopulmonary arrest, likely precipitated by underlying comorbidities including coronary artery disease and COPD. Discussion and Conclusion: This case highlights the potential severity of advanced prostatic tumors and the critical impact of systemic comorbidities on treatment outcomes.